1275763054 NPI number — MS. MEILING ASSUE R.D.

Table of content: MS. MEILING ASSUE R.D. (NPI 1275763054)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275763054 NPI number — MS. MEILING ASSUE R.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASSUE
Provider First Name:
MEILING
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
R.D.
Provider Gender Code:
F

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:
1275763054
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5700 42ND AVE
Provider Second Line Business Mailing Address:
APT 302
Provider Business Mailing Address City Name:
HYATTSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20781-1628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-280-7523
Provider Business Mailing Address Fax Number:
202-315-0423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7525 GREENWAY CENTER DR
Provider Second Line Business Practice Location Address:
STE 212
Provider Business Practice Location Address City Name:
GREENBELT
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20770-3525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-280-7523
Provider Business Practice Location Address Fax Number:
202-315-0423
Provider Enumeration Date:
07/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 053263400 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




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