| Doctor Name: | NOSTA TANYIDAH |
| NPI Number: | 1073918306 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | HHA10348 |
| Business Practice Address: | 7813 Mandan Rd T2 Greenbelt, MD - 207702139 |
| Business Phone Number: | 2023911159 |
| Business Fax Number: | |
| Mailing Address: | 7813 Mandan Rd, T2 GREENBELT |
| State: | MD |
| Postal Code: | 207702139 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2014 |
| NPI Last Update Date: | 10/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 305S00000X |
| License Number: | HHA10348 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DC |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Point of Service |
| Taxonomy Specialization: | |
| Taxonomy Definition: | This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |