Provider Demographics
NPI:1649749730
Name:ACOSTA, DENIA LOPEZ
Entity Type:Individual
Prefix:
First Name:DENIA
Middle Name:LOPEZ
Last Name:ACOSTA
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 1:3737 LEGATION ST NW APT 108
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1764
Mailing Address - Country:US
Mailing Address - Phone:305-562-6164
Mailing Address - Fax:
Practice Address - Street 1:6006 28TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-1506
Practice Address - Country:US
Practice Address - Phone:305-562-6164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant