Provider Demographics
NPI:1861753378
Name:SANNI, ISLAMIAT
Entity type:Individual
Prefix:
First Name:ISLAMIAT
Middle Name:
Last Name:SANNI
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 1:3815 64TH AVE
Mailing Address - Street 2:APT. # 204
Mailing Address - City:LANDOVER HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1822
Mailing Address - Country:US
Mailing Address - Phone:202-705-7861
Mailing Address - Fax:
Practice Address - Street 1:3815 64TH AVE
Practice Address - Street 2:APT. # 204
Practice Address - City:LANDOVER HILLS
Practice Address - State:MD
Practice Address - Zip Code:20784-1822
Practice Address - Country:US
Practice Address - Phone:202-705-7861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide