Provider Demographics
NPI:1376919761
Name:HAILEGIORGIS, TIRSIT T
Entity Type:Individual
Prefix:
First Name:TIRSIT
Middle Name:T
Last Name:HAILEGIORGIS
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 1:503 KENNEDY ST NW # 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-3009
Mailing Address - Country:US
Mailing Address - Phone:301-768-7341
Mailing Address - Fax:
Practice Address - Street 1:503 KENNEDY ST NW # 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-3009
Practice Address - Country:US
Practice Address - Phone:301-768-7341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide