Provider Demographics
NPI:1275004566
Name:SEFFA, KIRUBEL DANA
Entity Type:Individual
Prefix:
First Name:KIRUBEL
Middle Name:DANA
Last Name:SEFFA
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 1:7710 MAPLE AVE APT 1108
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5632
Mailing Address - Country:US
Mailing Address - Phone:240-779-1450
Mailing Address - Fax:
Practice Address - Street 1:820 UPSHUR ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5837
Practice Address - Country:US
Practice Address - Phone:202-723-0304
Practice Address - Fax:202-723-0367
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide