Provider Demographics
NPI:1376160705
Name:TESFAMARIAM, AZIEB (AZIEB)
Entity Type:Individual
Prefix:MS
First Name:AZIEB
Middle Name:
Last Name:TESFAMARIAM
Suffix:
Gender:F
Credentials:AZIEB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 15TH ST NW APT 403
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-5831
Mailing Address - Country:US
Mailing Address - Phone:202-827-8603
Mailing Address - Fax:
Practice Address - Street 1:2001 15TH ST NW APT 403
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-5831
Practice Address - Country:US
Practice Address - Phone:202-827-8603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant