1194991562 NPI number — LAILA EL-ASMAR LLC

Table of content: (NPI 1194991562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194991562 NPI number — LAILA EL-ASMAR LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAILA EL-ASMAR LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194991562
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1140 23RD ST NW
Provider Second Line Business Mailing Address:
APT 1003
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20037-1437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-257-7545
Provider Business Mailing Address Fax Number:
301-718-3633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7910 WOODMONT AVE
Provider Second Line Business Practice Location Address:
SUITE 460
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20814-3002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-656-9520
Provider Business Practice Location Address Fax Number:
301-718-3633
Provider Enumeration Date:
05/05/2008

Additional Information

Authorized Official

Authorized Official Last Name:
EL-ASMAR
Authorized Official First Name:
LAILA
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
301-656-9520

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  12920 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 12920 . This is a "STATE LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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