Provider Demographics
NPI:1457817728
Name:RICHARDSON, RASHAD ANTONIO
Entity Type:Individual
Prefix:
First Name:RASHAD
Middle Name:ANTONIO
Last Name:RICHARDSON
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 1:2110 ALICE AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3508
Mailing Address - Country:US
Mailing Address - Phone:301-852-1937
Mailing Address - Fax:
Practice Address - Street 1:100 I ST SE APT 1105
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4872
Practice Address - Country:US
Practice Address - Phone:240-640-3612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide