1821200692 NPI number — GREATER WASHINGTON URBAN LEAGUE AGING & HEALTH

Table of content: DR. MARIE CAROLE HAYDU OD (NPI 1073621496)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821200692 NPI number — GREATER WASHINGTON URBAN LEAGUE AGING & HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREATER WASHINGTON URBAN LEAGUE AGING & HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1821200692
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2901 14TH ST NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20009-6839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-265-8200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2901 14TH ST NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20009-6839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-265-8200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TURNER
Authorized Official First Name:
BRENDA
Authorized Official Middle Name:
LORRAINE
Authorized Official Title or Position:
DIRECTOR OF AGING & HEALTH SERVICES
Authorized Official Telephone Number:
202-265-8200

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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