Provider Demographics
NPI:1902456700
Name:ANTEH, HENRY ACHANGKERI
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:ACHANGKERI
Last Name:ANTEH
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 1:13026 OLD STAGE COACH RD APT 3720
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1619
Mailing Address - Country:US
Mailing Address - Phone:207-423-1296
Mailing Address - Fax:
Practice Address - Street 1:13026 OLD STAGE COACH RD APT 3720
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1619
Practice Address - Country:US
Practice Address - Phone:207-423-1296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide