Provider Demographics
NPI:1922605955
Name:CHEWAKA, HIRUT E
Entity Type:Individual
Prefix:
First Name:HIRUT
Middle Name:E
Last Name:CHEWAKA
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 1:1338 NICHOLSON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2836
Mailing Address - Country:US
Mailing Address - Phone:202-412-4039
Mailing Address - Fax:
Practice Address - Street 1:1338 NICHOLSON ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2836
Practice Address - Country:US
Practice Address - Phone:202-412-4039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA00187127Medicaid