Provider Demographics
NPI:1578973871
Name:GADO, FATHY
Entity Type:Individual
Prefix:
First Name:FATHY
Middle Name:
Last Name:GADO
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 1:8003 LAKECREST DR
Mailing Address - Street 2:#101
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3313
Mailing Address - Country:US
Mailing Address - Phone:301-825-6885
Mailing Address - Fax:
Practice Address - Street 1:8003 LAKECREST DR
Practice Address - Street 2:101
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3313
Practice Address - Country:US
Practice Address - Phone:301-825-6885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA8147374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide