Provider Demographics
NPI:1154749133
Name:AGYINGI, JUDE ACHAKI
Entity type:Individual
Prefix:
First Name:JUDE
Middle Name:ACHAKI
Last Name:AGYINGI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:942 MONTPELIER STREET
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21218
Mailing Address - Country:US
Mailing Address - Phone:443-345-7389
Mailing Address - Fax:410-662-7217
Practice Address - Street 1:942 MONTPELIER STREET
Practice Address - Street 2:
Practice Address - City:BALTIMORE CITY
Practice Address - State:MD
Practice Address - Zip Code:21218
Practice Address - Country:US
Practice Address - Phone:443-345-7389
Practice Address - Fax:410-662-7217
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10296374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide