Healthcare Provider Details

I. General information

NPI: 1619767217
Provider Name (Legal Business Name): EMMANUEL ERIC RASCO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 MEDICAL CENTER DR
ROCKVILLE MD
20850-3357
US

IV. Provider business mailing address

11210 WHITE BARN CT
GAITHERSBURG MD
20879-3146
US

V. Phone/Fax

Practice location:
  • Phone: 240-826-6202
  • Fax:
Mailing address:
  • Phone: 305-219-3574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN500013379
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR256523
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: