Provider Demographics
NPI:1497496962
Name:TAKWI, SAMMY AJAMI
Entity type:Individual
Prefix:
First Name:SAMMY
Middle Name:AJAMI
Last Name:TAKWI
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 1:7763 RIVERDALE RD APT 203
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3927
Mailing Address - Country:US
Mailing Address - Phone:443-454-4954
Mailing Address - Fax:
Practice Address - Street 1:9881 GOOD LUCK RD APT 5
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3234
Practice Address - Country:US
Practice Address - Phone:202-544-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 376K00000X
DCHHA200001866374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376K00000XNursing Service Related ProvidersNurse's Aide