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2759 Martin Luther King Jr Ave Se Ste 301 Washington DC 20032-2651 | |
| (202) 827-9961 | |
| (202) 827-9963 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 2759 Martin Luther King Jr Ave Se Ste 301, Washington, District Of Columbia |
| Authorized Official Name and Position | Luc Honore Petnji Yaya (CEO) |
| Authorized Official Contact | 2028279961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2759 Martin Luther King Jr Ave Se Ste 301 Washington DC 20032-2651 Ph: (202) 827-9961 | 2759 Martin Luther King Jr Ave Se Ste 301 Washington DC 20032-2651 Ph: (202) 827-9961 |
| NPI Number | 1437628914 |
|---|---|
| Provider Enumeration Date | 11/14/2018 |
| Last Update Date | 01/24/2024 |
| Certification Date | 01/24/2024 |
| Medicare PECOS PAC ID | 2668719501 |
|---|---|
| Medicare Enrollment ID | O20190130001464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437628914 | NPI | - | NPPES |
| Provider Name | Robbyn P Tureman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164621363 PECOS PAC ID: 7911948807 Enrollment ID: I20130315000079 |
| Provider Name | Wanda C Caesar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316288699 PECOS PAC ID: 7517104318 Enrollment ID: I20130515000556 |
| Provider Name | Amina Osman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952725152 PECOS PAC ID: 5991701419 Enrollment ID: I20160607000276 |
| Provider Name | Emmanuel Kamdem Sango |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770080483 PECOS PAC ID: 0143574038 Enrollment ID: I20181113000147 |
| Provider Name | Olufunmilayo S Onuoha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386177889 PECOS PAC ID: 5496090136 Enrollment ID: I20181227000924 |
| Provider Name | Adenike T Ojo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164772075 PECOS PAC ID: 5496082083 Enrollment ID: I20190805002449 |
| Provider Name | Stephane Tsague Ganhym |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073120572 PECOS PAC ID: 0143631259 Enrollment ID: I20201120002499 |
| Provider Name | Kenya Tenidea Saleh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790373025 PECOS PAC ID: 4385052406 Enrollment ID: I20210419001913 |
| Provider Name | Ayodeji Oladipo Somefun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831165380 PECOS PAC ID: 8123040854 Enrollment ID: I20220524000522 |
| Provider Name | Rosemary Oluwatoyin Fajemisin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093418709 PECOS PAC ID: 7810352358 Enrollment ID: I20230505000048 |
| Provider Name | Justina Seasi Adeti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376008037 PECOS PAC ID: 6406212976 Enrollment ID: I20230525002647 |
| Provider Name | Doris Davies |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932767472 PECOS PAC ID: 4688031065 Enrollment ID: I20230530001704 |
| Provider Name | Constantine Lewko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922470905 PECOS PAC ID: 7517203102 Enrollment ID: I20230929002919 |
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