Provider Demographics
NPI:1275602591
Name:CHARTERED FAMILY HELATH CENTER
Entity Type:Organization
Organization Name:CHARTERED FAMILY HELATH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:HEGAR
Authorized Official - Last Name:ALLEYNE
Authorized Official - Suffix:
Authorized Official - Credentials:CPNP
Authorized Official - Phone:202-398-8683
Mailing Address - Street 1:14815 CROSS RIVER CT
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-3105
Mailing Address - Country:US
Mailing Address - Phone:202-698-7342
Mailing Address - Fax:202-698-7028
Practice Address - Street 1:3924 MINNESOTA AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2661
Practice Address - Country:US
Practice Address - Phone:202-398-8683
Practice Address - Fax:202-627-7806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC363L00000X261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center