NPI 1194054072

Moni Sanusi

Practitioner Contractor Laurel, MD

Practice location

Address: 10121 Ancient Sea Path, Laurel, MD 20723
Phone: (301) 325-7188
Mailing address: 10121 Ancient Sea Path, Laurel, MD 20723-5862

Registered specialties (2)

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 23053 (MD)

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Specialist

Other Service Providers Taxonomy 174400000X Licence 23053 (MD)

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Registry record

NPI: 1194054072
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Dec 2009
Record last updated: 23 Dec 2009

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.