Provider Demographics
NPI:1902678287
Name:GLADYS HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:GLADYS HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:EGWUATU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-636-3511
Mailing Address - Street 1:2307 MANOR GATE TER
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8516
Mailing Address - Country:US
Mailing Address - Phone:240-636-3511
Mailing Address - Fax:
Practice Address - Street 1:2307 MANOR GATE TER
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8516
Practice Address - Country:US
Practice Address - Phone:240-636-3511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty