MEDICARE: LENSE AYELE FIRESA I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	HHA200004305	DC

General Provider Information

NPI Number	:	1194681239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LENSE AYELE FIRESA I

Provider Business Mailing Address
First Line	:	13015 MORNINGSIDE LN
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-3155
Country	:	US
Telephone Number	:	240-398-2852
Fax Number	:	240-398-2852

Provider Business Practice Location Address
First Line	:	13015 MORNINGSIDE LN
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-3155
Country	:	US
Telephone Number	:	240-398-2852
Fax Number	:	240-398-2852

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	04/28/2026

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Directions to “ LENSE AYELE FIRESA I ” Practice Location

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