Provider Demographics
NPI:1770264954
Name:ADESMAN, DANIELLE ROMANO (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ROMANO
Last Name:ADESMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N ST NW APT 219
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-5117
Mailing Address - Country:US
Mailing Address - Phone:516-724-1448
Mailing Address - Fax:
Practice Address - Street 1:5454 WISCONSIN AVE STE 1210
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6934
Practice Address - Country:US
Practice Address - Phone:301-215-5955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110009367363A00000X, 363AS0400X
MDC0008995363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant