Eziacess | |
2320 Iverson St Ste 100 Temple Hills MD 20748-6801 | |
(848) 256-0360 | |
Not Available |
Full Name | Eziacess |
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Speciality | Nurse Practitioner |
Location | 2320 Iverson St Ste 100, Temple Hills, Maryland |
Authorized Official Name and Position | Lucia Forbin (NURSE PRACTITIONER) |
Authorized Official Contact | 3015204135 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Eziacess 14511 Layhill Rd Silver Spring MD 20906-1914 Ph: () - | Eziacess 2320 Iverson St Ste 100 Temple Hills MD 20748-6801 Ph: (848) 256-0360 |
NPI Number | 1710497516 |
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Provider Enumeration Date | 10/05/2017 |
Last Update Date | 04/22/2022 |
Medicare PECOS PAC ID | 6608131388 |
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Medicare Enrollment ID | O20180530001080 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710497516 | NPI | - | NPPES |
14037773 | Other | MD | CAQH PROVIDER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QA0505X | Family Medicine - Adult Medicine | R155157 (Maryland) | Secondary |
363LF0000X | Nurse Practitioner - Family | R155157 (Maryland) | Primary |
Provider Name | Lucia Forbin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285175208 PECOS PAC ID: 4284905894 Enrollment ID: I20170731003522 |
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