1518623834 NPI number — FEVEN GEBREMARIAM PERSONAL CARE ATTEND

Table of content: FEVEN GEBREMARIAM PERSONAL CARE ATTEND (NPI 1518623834)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518623834 NPI number — FEVEN GEBREMARIAM PERSONAL CARE ATTEND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEBREMARIAM
Provider First Name:
FEVEN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PERSONAL CARE ATTEND
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:
1518623834
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1010 VERMONT AVE NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20005-4902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
844-381-4432
Provider Business Mailing Address Fax Number:
855-436-9066

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2945 MILLS AVE NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20018-2542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-426-6484
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2021

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: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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