Provider Demographics
NPI:1831450451
Name:NDISAH, RELINDIS BIH
Entity type:Individual
Prefix:
First Name:RELINDIS
Middle Name:BIH
Last Name:NDISAH
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 1:14720 4TH ST
Mailing Address - Street 2:#421
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3703
Mailing Address - Country:US
Mailing Address - Phone:213-379-3418
Mailing Address - Fax:
Practice Address - Street 1:14720 4TH ST
Practice Address - Street 2:#421
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3703
Practice Address - Country:US
Practice Address - Phone:213-379-3418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker