Provider Demographics
NPI:1194187112
Name:MAGNIGHAM TSE, CATHERINE CLARISSE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:CLARISSE
Last Name:MAGNIGHAM TSE
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 1:6223 64TH AVE
Mailing Address - Street 2:APT 5
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2948
Mailing Address - Country:US
Mailing Address - Phone:202-638-9623
Mailing Address - Fax:
Practice Address - Street 1:6223 64TH AVE
Practice Address - Street 2:APT 5
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-2948
Practice Address - Country:US
Practice Address - Phone:202-638-9623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11816374U00000X
DCNA00607488376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide