Provider Demographics
NPI:1861730608
Name:MAIMO, ERIC CHIN
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:CHIN
Last Name:MAIMO
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 1:6731 NEW HAMPSHIRE AVE APT 406
Mailing Address - Street 2:TAKOMA PARK
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-2801
Mailing Address - Country:US
Mailing Address - Phone:301-404-0935
Mailing Address - Fax:
Practice Address - Street 1:6731 NEW HAMPSHIRE AVE APT 406
Practice Address - Street 2:TAKOMA PARK
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-2801
Practice Address - Country:US
Practice Address - Phone:301-404-0935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
DCNA00804318376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide