Provider Demographics
NPI:1104166677
Name:KASSEGN, BEKRE ADBARU (RPSGT)
Entity type:Individual
Prefix:MR
First Name:BEKRE
Middle Name:ADBARU
Last Name:KASSEGN
Suffix:
Gender:M
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 19TH ST NE
Mailing Address - Street 2:#4
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4090
Mailing Address - Country:US
Mailing Address - Phone:240-330-2714
Mailing Address - Fax:
Practice Address - Street 1:908 19TH ST NE
Practice Address - Street 2:#4
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4090
Practice Address - Country:US
Practice Address - Phone:240-330-2714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC16189246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic