Basic Information
| Provider Information | |||||||||
| NPI: | 1326480401 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TANWI | ||||||||
| FirstName: | ALAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5902 31ST AVE APT 205 | ||||||||
| Address2: | |||||||||
| City: | HYATTSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207822903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017230229 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5856 EASTERN AVE. NE | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2025450211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2013 | ||||||||
| LastUpdateDate: | 07/18/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374U00000X | Y | Nursing Service Related Providers | Home Health Aide |
No ID Information.