Provider Demographics
NPI:1083252738
Name:GAJIYEVA, LIYANA
Entity Type:Individual
Prefix:MRS
First Name:LIYANA
Middle Name:
Last Name:GAJIYEVA
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 1:4000 MASSACHUSETTS AVE NW APT 1010
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-5112
Mailing Address - Country:US
Mailing Address - Phone:202-730-5210
Mailing Address - Fax:
Practice Address - Street 1:4000 MASSACHUSETTS AVE NW APT 1010
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-5112
Practice Address - Country:US
Practice Address - Phone:202-730-5210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant