Provider Demographics
NPI:1467857045
Name:GOLDBERG & ASSEFA LLC
Entity Type:Organization
Organization Name:GOLDBERG & ASSEFA LLC
Other - Org Name:TULSI HOLISTIC LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAWIT
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSEFA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:202-378-8033
Mailing Address - Street 1:5125 MACARTHUR BLVD NW
Mailing Address - Street 2:SUITE 15
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3300
Mailing Address - Country:US
Mailing Address - Phone:202-333-7025
Mailing Address - Fax:
Practice Address - Street 1:5125 MACARTHUR BLVD NW
Practice Address - Street 2:SUITE 15
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3300
Practice Address - Country:US
Practice Address - Phone:202-333-7025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-25
Last Update Date:2014-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC500073171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty