1669915708 NPI number — DR. JOANNA M. CHANGO-JAMES PH.D.

Table of content: DR. JOANNA M. CHANGO-JAMES PH.D. (NPI 1669915708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669915708 NPI number — DR. JOANNA M. CHANGO-JAMES PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHANGO-JAMES
Provider First Name:
JOANNA
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669915708
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
627 S PATTERSON PARK AVE
Provider Second Line Business Mailing Address:
APT. 2
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21231-3215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-350-7116
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 WILSON BLVD
Provider Second Line Business Practice Location Address:
SUITE 412
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22201-3397
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-328-5577
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/21/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  0810005236 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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