Healthcare Provider Details

I. General information

NPI: 1780382739
Provider Name (Legal Business Name): BERHANE HAFISO TERORO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9607 MCWHORTER FARM CT
DAMASCUS MD
20872-3302
US

IV. Provider business mailing address

8014 FLOWER AVE APT 1
TAKOMA PARK MD
20912-6819
US

V. Phone/Fax

Practice location:
  • Phone: 240-405-4528
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200002580
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberA00203331
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: