Provider Demographics
NPI:1528417359
Name:FON, DESMOND
Entity Type:Individual
Prefix:
First Name:DESMOND
Middle Name:
Last Name:FON
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 1:502 KENNEDY ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-3136
Mailing Address - Country:US
Mailing Address - Phone:202-313-7283
Mailing Address - Fax:202-545-1645
Practice Address - Street 1:502 KENNEDY ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-3136
Practice Address - Country:US
Practice Address - Phone:202-313-7283
Practice Address - Fax:202-545-1645
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide