Provider Demographics
NPI:1841602620
Name:TANDA, CHARLES
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:TANDA
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 1:7826 EASTERN AVE NW, SUITE 400
Mailing Address - Street 2:ALLIANCE HOME HEALTH CARE AGENCY, INC
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1324
Mailing Address - Country:US
Mailing Address - Phone:202-545-1630
Mailing Address - Fax:202-545-1645
Practice Address - Street 1:7826 EASTERN AVE NW STE 400
Practice Address - Street 2:BERHAN HOME HEALTH AGENCY, INC
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1316
Practice Address - Country:US
Practice Address - Phone:202-545-1630
Practice Address - Fax:202-545-1630
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10492374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide