Provider Demographics
NPI:1437792850
Name:MADIROSE
Entity Type:Organization
Organization Name:MADIROSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-739-2273
Mailing Address - Street 1:105 ORONOCO ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2089
Mailing Address - Country:US
Mailing Address - Phone:703-739-2273
Mailing Address - Fax:
Practice Address - Street 1:105 ORONOCO ST STE 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2089
Practice Address - Country:US
Practice Address - Phone:703-739-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care