Healthcare Provider Details

I. General information

NPI: 1326407784
Provider Name (Legal Business Name): DEENA BABU P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEENA ZACHARIA P.A.

II. Dates (important events)

Enumeration Date: 02/14/2016
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW STE 301
WASHINGTON DC
20010-2927
US

IV. Provider business mailing address

13225 COPLAND CT
SILVER SPRING MD
20904-7102
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-7788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0007333
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number019209
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA031673
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: