Provider Demographics
NPI:1295440956
Name:MILGROM, SARAFINA
Entity type:Individual
Prefix:
First Name:SARAFINA
Middle Name:
Last Name:MILGROM
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 1:1150 RIPLEY ST APT 717
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-7422
Mailing Address - Country:US
Mailing Address - Phone:201-925-6392
Mailing Address - Fax:
Practice Address - Street 1:1350 CONNECTICUT AVE NW STE 602
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1716
Practice Address - Country:US
Practice Address - Phone:202-854-1838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000021041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical