Provider Demographics
NPI:1053968610
Name:ELERIBE, STANLEY IFEANYI
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:IFEANYI
Last Name:ELERIBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8807 HUNTING LN APT 201
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1211
Mailing Address - Country:US
Mailing Address - Phone:240-810-3164
Mailing Address - Fax:
Practice Address - Street 1:8807 HUNTING LN APT 201
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1211
Practice Address - Country:US
Practice Address - Phone:202-904-5106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant