Provider Demographics
NPI:1154076545
Name:SIEGNANG, IRENE
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:SIEGNANG
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 1:6163 64TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2915
Mailing Address - Country:US
Mailing Address - Phone:240-701-0545
Mailing Address - Fax:
Practice Address - Street 1:3578 HAYES ST NE APT 102
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-7504
Practice Address - Country:US
Practice Address - Phone:202-215-0671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant