Provider Demographics
NPI:1619545571
Name:KITANA, FARAH ISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:FARAH
Middle Name:ISSA
Last Name:KITANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-2835
Mailing Address - Fax:202-877-8288
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-2835
Practice Address - Fax:202-877-8288
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2023-04-07
Deactivation Date:2023-04-06
Deactivation Code:
Reactivation Date:2023-04-07
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program