Provider Demographics
NPI:1356606818
Name:412 RITTENHOUSE ST NW WASHINGTON DC 20011
Entity type:Organization
Organization Name:412 RITTENHOUSE ST NW WASHINGTON DC 20011
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:AHOUEFA
Authorized Official - Last Name:HOUEDOU
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:202-384-2143
Mailing Address - Street 1:412 RITTENHOUSE ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1329
Mailing Address - Country:US
Mailing Address - Phone:202-384-2143
Mailing Address - Fax:
Practice Address - Street 1:412 RITTENHOUSE ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1329
Practice Address - Country:US
Practice Address - Phone:202-384-2143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD163W00000X281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital