Provider Demographics
NPI:1134565385
Name:ACHU, MARTIN NYANGA (HHA)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:NYANGA
Last Name:ACHU
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8812 HUNTING LN APT 103
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1248
Mailing Address - Country:US
Mailing Address - Phone:240-353-6329
Mailing Address - Fax:
Practice Address - Street 1:8812 HUNTING LN APT 103
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1248
Practice Address - Country:US
Practice Address - Phone:240-353-6329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide