Healthcare Provider Details

I. General information

NPI: 1578985388
Provider Name (Legal Business Name): RAZIA RAFIQUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2014
Last Update Date: 01/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 MARYLAND AVE NE APT 109
WASHINGTON DC
20002-3125
US

IV. Provider business mailing address

1909 MARYLAND AVE NE APT 109
WASHINGTON DC
20002-3125
US

V. Phone/Fax

Practice location:
  • Phone: 202-460-5145
  • Fax:
Mailing address:
  • Phone: 202-460-5145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA6222
License Number StateDC

VIII. Authorized Official

Name: MS. RAZIA RAFIQUE
Title or Position: HHA
Credential:
Phone: 202-460-5145