Provider Demographics
NPI:1255671038
Name:GESSESSE, ERMIAS ABEBE (SLEEP TECH)
Entity Type:Individual
Prefix:MR
First Name:ERMIAS
Middle Name:ABEBE
Last Name:GESSESSE
Suffix:
Gender:M
Credentials:SLEEP TECH
Other - Prefix:
Other - First Name:ERMIAS
Other - Middle Name:ABEBE
Other - Last Name:GESSESSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLEEP TECH
Mailing Address - Street 1:8668 PINEY BRANCH RD
Mailing Address - Street 2:201
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-3903
Mailing Address - Country:US
Mailing Address - Phone:240-640-1772
Mailing Address - Fax:
Practice Address - Street 1:50 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:202-518-4624
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17660246ZE0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2960OtherTHE AMERICAN BOARD OF SLEEP MEDICINE
MD17660OtherRPSGT
MD215878OtherMD SLEEP TECH LICENCE