Provider Demographics
NPI:1134636731
Name:HOGARTY, DJENABA CAMARA
Entity Type:Individual
Prefix:
First Name:DJENABA
Middle Name:CAMARA
Last Name:HOGARTY
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 1:1556 NORTHGATE SQ APT 32
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3781
Mailing Address - Country:US
Mailing Address - Phone:301-257-0350
Mailing Address - Fax:
Practice Address - Street 1:1556 NORTHGATE SQ APT 32
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3781
Practice Address - Country:US
Practice Address - Phone:301-257-0350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant