Basic Information
Provider Information
NPI: 1427639806
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ATEM
FirstName: SYLVIA
MiddleName: LEKEAKA
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4606 MARGIE CT
Address2:  
City: LANHAM
State: MD
PostalCode: 207061984
CountryCode: US
TelephoneNumber: 4105708884
FaxNumber:  
Practice Location
Address1: 2512 24TH ST NE
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200182126
CountryCode: US
TelephoneNumber: 2028328340
FaxNumber: 2028328341
Other Information
ProviderEnumerationDate: 04/18/2021
LastUpdateDate: 04/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
374U00000XHHA15340DCY Nursing Service Related ProvidersHome Health Aide 

No ID Information.


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