Provider Demographics
NPI:1689320772
Name:ACEVEDO DE GARCIA, CECILIA YANETH
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:YANETH
Last Name:ACEVEDO DE GARCIA
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 1:15 RIGGS RD NE APT 135
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2447
Mailing Address - Country:US
Mailing Address - Phone:301-723-1125
Mailing Address - Fax:
Practice Address - Street 1:1740 EUCLID ST NW APT 105
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2835
Practice Address - Country:US
Practice Address - Phone:202-234-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-27
Last Update Date:2022-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant