Provider Demographics
NPI:1568721124
Name:ASSIGNO, DEDE ANTOINETTE
Entity Type:Individual
Prefix:MRS
First Name:DEDE
Middle Name:ANTOINETTE
Last Name:ASSIGNO
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 1:1500 KANAWHA ST APT 107
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-6862
Mailing Address - Country:US
Mailing Address - Phone:703-587-8383
Mailing Address - Fax:
Practice Address - Street 1:1500 KANAWHA ST APT 107
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-6862
Practice Address - Country:US
Practice Address - Phone:703-587-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
MD374U00000X
A225139067369374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide