Gt Healthcare INC
Nurse Practitioner, Psych/Mental Health in White Plains, MD. Organization (NPI-2).
NPI number1003552159
StatusActive
Last updated in NPPESMay 11, 2022
Details
- NPI
- 1003552159
- Entity type
- Organization (NPI-2)
- Legal business name
- Gt Healthcare INC
- Organization subpart
- No
- Enumeration date
- May 11, 2022
- Certification date
- May 11, 2022
- Last updated
- May 11, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
| 363L00000X | Nurse Practitioner | – | – |
Practice location
10515 Theodore Green Blvd Ste 212White Plains, MD 20695-3044
Phone 202-246-3013 · Fax 202-246-3013
Mailing address
10515 Theodore Green Blvd Ste 212White Plains, MD 20695-3044
Phone 202-246-3013 · Fax 202-246-3013
Authorized official
Oluwatosin Fanimo
Owner/Provider
2022463013
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