Provider Demographics
NPI:1902199771
Name:TSEGAZEAB, RUFAEL S (PHARM D)
Entity Type:Individual
Prefix:
First Name:RUFAEL
Middle Name:S
Last Name:TSEGAZEAB
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 1ST ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4274
Mailing Address - Country:US
Mailing Address - Phone:202-589-0127
Mailing Address - Fax:202-589-0758
Practice Address - Street 1:1201 1ST ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4274
Practice Address - Country:US
Practice Address - Phone:202-589-0127
Practice Address - Fax:202-589-0758
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH100000244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist