Provider Demographics
NPI:1174863013
Name:NJUSAM, CHRISTOPHER
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:NJUSAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3813 64TH AVE
Mailing Address - Street 2:APT 203
Mailing Address - City:LANDOVER HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1820
Mailing Address - Country:US
Mailing Address - Phone:301-323-5442
Mailing Address - Fax:
Practice Address - Street 1:7907 EAST VALLEY RD
Practice Address - Street 2:
Practice Address - City:LANDOVER HILLS
Practice Address - State:MD
Practice Address - Zip Code:20785-1820
Practice Address - Country:US
Practice Address - Phone:301-323-5442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DCLPN1008955164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide