Provider Demographics
NPI:1629889159
Name:SHANO, AMANUEL BORANA (YES)
Entity type:Individual
Prefix:
First Name:AMANUEL
Middle Name:BORANA
Last Name:SHANO
Suffix:
Gender:M
Credentials:YES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LOTUS LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-6834
Mailing Address - Country:US
Mailing Address - Phone:202-492-4216
Mailing Address - Fax:
Practice Address - Street 1:9 LOTUS LN
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-6834
Practice Address - Country:US
Practice Address - Phone:202-492-4216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company