Healthcare Provider Details

I. General information

NPI: 1437372356
Provider Name (Legal Business Name): HADAS GEBRAL TESFAI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 LANDOVER ROAD
CHEVERLY MD
20785
US

IV. Provider business mailing address

7402 POTOMAC CT
NEW CARROLLTON MD
20784-3660
US

V. Phone/Fax

Practice location:
  • Phone: 301-773-1111
  • Fax:
Mailing address:
  • Phone: 301-552-3110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR120149
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: