Provider Demographics
NPI:1336600097
Name:DIAZ DEL CID DE MAJAN, DONATILA
Entity Type:Individual
Prefix:
First Name:DONATILA
Middle Name:
Last Name:DIAZ DEL CID DE MAJAN
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 1:7401 NEW HAMPSHIRE AVE APT 1109
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6955
Mailing Address - Country:US
Mailing Address - Phone:240-917-1375
Mailing Address - Fax:
Practice Address - Street 1:1719 EVARTS ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2029
Practice Address - Country:US
Practice Address - Phone:202-213-6423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant