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General NPI Number Information
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NPI Number | 1336023696
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Entity Type | Individual
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Provider Name | ADOM GUESH BRHANE
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Gender | Female
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 6564 LOISDALE CT
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City | SPRINGFIELD
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State | VA
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Zip | 22150-1827
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Country | US
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Telephone | 703-850-0192
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Fax |
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Provider Business Mailing Address
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Address Line | 6016 AMHERST AVE
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City | SPRINGFIELD
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State | VA
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Zip | 22150-3227
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Country | US
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Telephone | 703-850-0192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State | VA
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