Provider Demographics
NPI:1356706584
Name:TAH, SYLVIA ANGUM (HOME HEALTH AIDE)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:ANGUM
Last Name:TAH
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 QUEENS CHAPEL RD APT 204
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3653
Mailing Address - Country:US
Mailing Address - Phone:240-467-6601
Mailing Address - Fax:
Practice Address - Street 1:2600 QUEENS CHAPEL RD APT 204
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3653
Practice Address - Country:US
Practice Address - Phone:240-467-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11583374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCHHA11583OtherHOME HEALTH AIDE