Provider Demographics
NPI:1780270181
Name:BERHANE, YONAS
Entity type:Individual
Prefix:
First Name:YONAS
Middle Name:
Last Name:BERHANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8544 SPRINGFIELD OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-3542
Mailing Address - Country:US
Mailing Address - Phone:571-234-9154
Mailing Address - Fax:
Practice Address - Street 1:8544 SPRINGFIELD OAKS DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22153-3542
Practice Address - Country:US
Practice Address - Phone:571-234-9154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program