NPI 1033626635

Jude Thaddeus Yusimbom Song, HOMEHEALTHAIDE

Practitioner Licensed Practical Nurse Washington, DC

Practice location

Address: 2811 Pennsylvania Ave SE, Washington, DC 20020-3865
Phone: (202) 894-6811
Fax: (202) 894-6811
Mailing address: 5501 Doris CT, Bladensburg, MD 20710-1649

Registered specialties (4)

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence LPN200002497 (DC)

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Case Manager/Care Coordinator

Other Service Providers Taxonomy 171M00000X

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Home Health Aide

Nursing Service Related Providers Taxonomy 374U00000X Licence HHA13466 (DC)

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Nurse's Aide

Nursing Service Related Providers Taxonomy 376K00000X Licence 256963753 (DC)

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Registry record

NPI: 1033626635
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Jan 2018
Record last updated: 14 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.