Provider Demographics
NPI:1548525447
Name:MBARAK, BAKIRA HUSSEIN
Entity type:Individual
Prefix:
First Name:BAKIRA
Middle Name:HUSSEIN
Last Name:MBARAK
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 1:11550 LOCKWOOD DR APT C2
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2429
Mailing Address - Country:US
Mailing Address - Phone:202-290-3487
Mailing Address - Fax:202-290-3487
Practice Address - Street 1:11550 LOCKWOOD DR APT C2
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2429
Practice Address - Country:US
Practice Address - Phone:202-290-3487
Practice Address - Fax:202-290-3487
Is Sole Proprietor?:No
Enumeration Date:2012-07-07
Last Update Date:2012-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide