Provider Demographics
NPI:1407515463
Name:KEMAL, HASSAN MOHAMMED
Entity Type:Individual
Prefix:
First Name:HASSAN
Middle Name:MOHAMMED
Last Name:KEMAL
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 1:12746 MILAN CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-7641
Mailing Address - Country:US
Mailing Address - Phone:703-477-9380
Mailing Address - Fax:
Practice Address - Street 1:1325 UPSHUR ST NW APT 102
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5651
Practice Address - Country:US
Practice Address - Phone:703-477-9381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant