Healthcare Provider Details

I. General information

NPI: 1215286901
Provider Name (Legal Business Name): ELIZABETH YIRDAW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 11/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 VERMONT AVE NW STE 1003
WASHINGTON DC
20005-4927
US

IV. Provider business mailing address

7826 EASTERN AVE NW STE 400
WASHINGTON DC
20012-1316
US

V. Phone/Fax

Practice location:
  • Phone: 844-381-4432
  • Fax:
Mailing address:
  • Phone: 202-545-1630
  • Fax: 202-545-1645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: