Provider Demographics
NPI:1245934306
Name:AGYEI, ANGELINA FREMA
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:FREMA
Last Name:AGYEI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 FOREST POINT CIR STE 131
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4743
Mailing Address - Country:US
Mailing Address - Phone:703-479-1117
Mailing Address - Fax:703-479-2191
Practice Address - Street 1:9300 FOREST POINT CIR STE 131
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4743
Practice Address - Country:US
Practice Address - Phone:703-479-1117
Practice Address - Fax:703-479-2191
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2731343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)