Provider Demographics
NPI:1548717937
Name:AZOH, SANDRINE
Entity type:Individual
Prefix:
First Name:SANDRINE
Middle Name:
Last Name:AZOH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 BLACKBURN LN
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1769
Mailing Address - Country:US
Mailing Address - Phone:240-938-6503
Mailing Address - Fax:
Practice Address - Street 1:3905 BLACKBURN LN
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1769
Practice Address - Country:US
Practice Address - Phone:240-938-6503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12331374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide