Basil E Fomanka
Basil E Fomanka is a Nurse Practitioner in Riverdale, Maryland. Qualified in 2022, 4 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Maryland.
- Years since qualifying
- 4
- Licensed in
- MD
- In the registry since
- 2023
Practice location Address checks out
6200 Baltimore Ave 300-R9Riverdale, MD 20737-1054
Phone: (443) 520-8138
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric/Mental Health Nurse Practitioner (primary) | Taxonomy 363LP0808X · Licence R198010 (MD) |
|---|
Record details
| NPI number | 1013621010 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | January 13, 2023 |
| Last updated in NPPES | September 18, 2025 |
| Certification date | September 18, 2025 |
| Mailing address | 6200 Baltimore Ave Ste 300-R9, Riverdale, MD 20737-1054 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2022 (4 years in practice) |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |
Other providers in Riverdale
-
John Adelaja Adeleye, CRNP-PMH
6801 Kenilworth Ave Ste 300S2, Riverdale, MD 20737-1331 · (301) 512-9448
-
Dorothy Akakem
6103 Baltimore Ave, Riverdale, MD 20737-1966 · (240) 602-4164
-
Dynmed Primary Care and Wellness P. A
6510 Kenilworth Ave Ste 2700, Riverdale, MD 20737-1353 · (301) 526-1004
-
Gofan Healthcare Service LLC
6200 Baltimore Ave Ste 300, Riverdale, MD 20737-1054 · (469) 296-8177
-
Klarity Behavioral Health LLC
6801 Kenilworth Ave Ste 300, Riverdale, MD 20737-1331 · (240) 838-6354
-
Nkechi Nikki Franca Ukwandu, MSN, PMHMNP
4404 Queensbury Rd, Riverdale, MD 20737-1068 · (202) 509-7000
-
William-Micah Psychiatric Services LLC
6811 Kenilworth Ave Ste 500-E12, Riverdale, MD 20737-1333 · (301) 412-1594