Healthcare Provider Details

I. General information

NPI: 1871743161
Provider Name (Legal Business Name): CHRISTINE ROSTAMI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 09/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 SPRING RD NW
WASHINGTON DC
20010-1421
US

IV. Provider business mailing address

1125 SPRING RD NW
WASHINGTON DC
20010-1421
US

V. Phone/Fax

Practice location:
  • Phone: 202-576-7173
  • Fax:
Mailing address:
  • Phone: 202-576-7173
  • Fax: 202-576-3203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN42951
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRO75225
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: