Healthcare Provider Details

I. General information

NPI: 1992515233
Provider Name (Legal Business Name): FEDERICO CARRARA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 RHODE ISLAND AVE NW
WASHINGTON DC
20001-4153
US

IV. Provider business mailing address

1010 HALF ST SE APT 1165
WASHINGTON DC
20003-4195
US

V. Phone/Fax

Practice location:
  • Phone: 202-232-6100
  • Fax: 202-644-7024
Mailing address:
  • Phone: 415-972-9633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: