Provider Demographics
NPI:1356172787
Name:KAFIBE, JOEL KAFIBE
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:KAFIBE
Last Name:KAFIBE
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 1:9685 MUIRKIRK RD APT B78
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2612
Mailing Address - Country:US
Mailing Address - Phone:301-532-5005
Mailing Address - Fax:
Practice Address - Street 1:4645 NANNIE HELEN BURROUGHS AVE NE # DC20019
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3622
Practice Address - Country:US
Practice Address - Phone:301-532-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator