Provider Demographics
NPI:1457753147
Name:GEBREEGZABHER, ASTER
Entity Type:Individual
Prefix:
First Name:ASTER
Middle Name:
Last Name:GEBREEGZABHER
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 1:13049 SHEFFIELD MANOR DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7204
Mailing Address - Country:US
Mailing Address - Phone:202-246-9054
Mailing Address - Fax:
Practice Address - Street 1:7333 NEW HAMPSHIRE AVE
Practice Address - Street 2:APT 408
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6958
Practice Address - Country:US
Practice Address - Phone:202-246-9054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1004417164W00000X
DCHHA12692374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No164W00000XNursing Service ProvidersLicensed Practical Nurse