Provider Demographics
NPI:1700216348
Name:BATHILY, HADIA ASTA I
Entity Type:Individual
Prefix:
First Name:HADIA
Middle Name:ASTA
Last Name:BATHILY
Suffix:I
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 1:9110 PINEY BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2815
Mailing Address - Country:US
Mailing Address - Phone:202-299-4832
Mailing Address - Fax:
Practice Address - Street 1:9110 PINEY BRANCH RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2815
Practice Address - Country:US
Practice Address - Phone:202-299-4832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10011374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide