Provider Demographics
NPI:1518397389
Name:ABIA, TAMBE
Entity type:Individual
Prefix:
First Name:TAMBE
Middle Name:
Last Name:ABIA
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 1:4317 28TH PL
Mailing Address - Street 2:APT 4
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1534
Mailing Address - Country:US
Mailing Address - Phone:240-898-5284
Mailing Address - Fax:
Practice Address - Street 1:4317 28TH PL
Practice Address - Street 2:APT 4
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1534
Practice Address - Country:US
Practice Address - Phone:240-898-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide