Provider Demographics
NPI:1154683324
Name:MHINA, STEPHANO
Entity Type:Individual
Prefix:
First Name:STEPHANO
Middle Name:
Last Name:MHINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 KENNEDY ST NW STE 3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5270
Mailing Address - Country:US
Mailing Address - Phone:202-450-4122
Mailing Address - Fax:
Practice Address - Street 1:143 KENNEDY ST NW STE 3
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5270
Practice Address - Country:US
Practice Address - Phone:202-450-4122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide