Provider Demographics
NPI:1568249530
Name:DOROSHKO, OLENA
Entity Type:Individual
Prefix:
First Name:OLENA
Middle Name:
Last Name:DOROSHKO
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 1:6119 BALFOUR DR
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-1504
Mailing Address - Country:US
Mailing Address - Phone:201-466-8562
Mailing Address - Fax:
Practice Address - Street 1:3335 D ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2302
Practice Address - Country:US
Practice Address - Phone:202-489-4951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant