Healthcare Provider Details

I. General information

NPI: 1952948044
Provider Name (Legal Business Name): RABAAELADAWIA M HASSAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2019
Last Update Date: 12/08/2019
Certification Date: 12/08/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 BUTTERWORTH PL NW
WASHINGTON DC
20016-4538
US

IV. Provider business mailing address

721 MONROE ST APT 101
ROCKVILLE MD
20850-2711
US

V. Phone/Fax

Practice location:
  • Phone: 202-876-6872
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberT22365
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: