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General NPI Number Information
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NPI Number | 1780382739
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Entity Type | Individual
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Provider Name | BERHANE HAFISO TERORO
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Gender | Female
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 9607 MCWHORTER FARM CT
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City | DAMASCUS
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State | MD
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Zip | 20872-3302
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Country | US
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Telephone | 240-405-4528
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Fax |
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Provider Business Mailing Address
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Address Line | 8014 FLOWER AVE APT 1
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City | TAKOMA PARK
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State | MD
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Zip | 20912-6819
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Country | US
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Telephone |
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | A00203331
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA200002580
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License Number State | DC
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