Provider Demographics
NPI:1619775327
Name:AJUKO, ITA ANGWEI
Entity type:Individual
Prefix:
First Name:ITA
Middle Name:ANGWEI
Last Name:AJUKO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9909 GREENBELT RD APT 204
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2242
Mailing Address - Country:US
Mailing Address - Phone:227-205-8006
Mailing Address - Fax:
Practice Address - Street 1:9909 GREENBELT RD APT 204
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2242
Practice Address - Country:US
Practice Address - Phone:227-205-8006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200004644374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide