Provider Demographics
NPI:1508217076
Name:BASHER, BAHRYA BADRU
Entity Type:Individual
Prefix:
First Name:BAHRYA
Middle Name:BADRU
Last Name:BASHER
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 1:1434 SOMERSET PL NW APT A3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1056
Mailing Address - Country:US
Mailing Address - Phone:202-340-1058
Mailing Address - Fax:
Practice Address - Street 1:1434 SOMERSET PL NW APT A3
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1056
Practice Address - Country:US
Practice Address - Phone:202-340-1058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11083374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide