Healthcare Provider Details

I. General information

NPI: 1396495370
Provider Name (Legal Business Name): AFFINITY CARE OF DC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 VARNUM ST NE STE 208B
WASHINGTON DC
20017-2153
US

IV. Provider business mailing address

1140 VARNUM ST NE STE 208B
WASHINGTON DC
20017-2153
US

V. Phone/Fax

Practice location:
  • Phone: 202-800-9006
  • Fax: 202-478-5016
Mailing address:
  • Phone: 202-800-9006
  • Fax: 202-478-5016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL STERN
Title or Position: CEO
Credential:
Phone: 510-499-9977