Provider Demographics
NPI:1639783970
Name:ACHARYA, NATHANIEL FORREST
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:FORREST
Last Name:ACHARYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 BREWSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-3161
Mailing Address - Country:US
Mailing Address - Phone:608-960-6067
Mailing Address - Fax:
Practice Address - Street 1:3217 ADAMS MILL RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-1008
Practice Address - Country:US
Practice Address - Phone:202-491-4348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant