Provider Demographics
NPI:1073153383
Name:SOCKWELL, CORA
Entity Type:Individual
Prefix:
First Name:CORA
Middle Name:
Last Name:SOCKWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 CAPITOL AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2221
Mailing Address - Country:US
Mailing Address - Phone:202-280-9719
Mailing Address - Fax:
Practice Address - Street 1:2611 RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-4016
Practice Address - Country:US
Practice Address - Phone:202-892-9372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant