Provider Demographics
NPI:1518677004
Name:ASANJI, BERTRAND
Entity Type:Individual
Prefix:
First Name:BERTRAND
Middle Name:
Last Name:ASANJI
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 1:7701 TOPTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2957
Mailing Address - Country:US
Mailing Address - Phone:202-446-8465
Mailing Address - Fax:
Practice Address - Street 1:7701 TOPTON ST
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-2957
Practice Address - Country:US
Practice Address - Phone:202-446-8465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-25
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health