Provider Demographics
NPI:1578892758
Name:NEDHARI, AZA (CPM, LGPC)
Entity Type:Individual
Prefix:MS
First Name:AZA
Middle Name:
Last Name:NEDHARI
Suffix:
Gender:F
Credentials:CPM, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-4016
Mailing Address - Country:US
Mailing Address - Phone:202-746-7801
Mailing Address - Fax:202-601-0485
Practice Address - Street 1:3500 DUKE ST
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-4016
Practice Address - Country:US
Practice Address - Phone:202-746-7801
Practice Address - Fax:202-601-0485
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X, 374J00000X
MDDEM00024176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty
No374J00000XNursing Service Related ProvidersDoula