Provider Demographics
NPI:1346006608
Name:AMAYA FERRUFINO, SARA ILCIA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ILCIA
Last Name:AMAYA FERRUFINO
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 1:5005 11TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2849
Mailing Address - Country:US
Mailing Address - Phone:202-409-2463
Mailing Address - Fax:
Practice Address - Street 1:5074 G ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5901
Practice Address - Country:US
Practice Address - Phone:240-779-7934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant