Provider Demographics
NPI:1639068265
Name:MUSHALA, KALAYI-TEUKA
Entity type:Individual
Prefix:
First Name:KALAYI-TEUKA
Middle Name:
Last Name:MUSHALA
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 1:1206 RANDOLPH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2628
Mailing Address - Country:US
Mailing Address - Phone:202-316-7685
Mailing Address - Fax:
Practice Address - Street 1:1206 RANDOLPH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2628
Practice Address - Country:US
Practice Address - Phone:202-316-7685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide