Provider Demographics
NPI:1720388424
Name:TSEGGAY, FESSEHAYE HAGOS (RPH)
Entity Type:Individual
Prefix:MR
First Name:FESSEHAYE
Middle Name:HAGOS
Last Name:TSEGGAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 PINEY BRANCH RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2900
Mailing Address - Country:US
Mailing Address - Phone:202-723-5612
Mailing Address - Fax:202-722-4113
Practice Address - Street 1:6500 PINEY BRANCH RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2900
Practice Address - Country:US
Practice Address - Phone:202-723-5612
Practice Address - Fax:202-722-4113
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPHA3055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist