Provider Demographics
NPI:1053041699
Name:GEORGETOWN UNIVERSITY
Entity Type:Organization
Organization Name:GEORGETOWN UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DNAP PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LADAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESHKEVARI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CRNA
Authorized Official - Phone:202-687-3912
Mailing Address - Street 1:3039 Q ST NW APT 30
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-3095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3700 RESERVOIR RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2111
Practice Address - Country:US
Practice Address - Phone:202-687-3912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty