MEDICARE: BRUNHILA ASAMBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1376886184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUNHILA ASAMBA

Provider Business Mailing Address
First Line	:	6733 NEW HAMPSHIRE AVE
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4864
Country	:	US
Telephone Number	:	513-237-5610
Fax Number	:

Provider Business Practice Location Address
First Line	:	6120 KANSAS AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011
Country	:	US
Telephone Number	:	202-722-7776
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2013
Last Update Date	:	03/29/2013

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