Provider Demographics
NPI:1215781679
Name:REZENE, AIDA (DO)
Entity type:Individual
Prefix:MS
First Name:AIDA
Middle Name:
Last Name:REZENE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4151 BLADENBURG RD
Mailing Address - Street 2:
Mailing Address - City:COLMAR MANOR
Mailing Address - State:MD
Mailing Address - Zip Code:20722
Mailing Address - Country:US
Mailing Address - Phone:301-699-7077
Mailing Address - Fax:301-779-9001
Practice Address - Street 1:4151 BLADENBURG RD
Practice Address - Street 2:DEPARTMENT OF FAMILY MEDICINE
Practice Address - City:COLMAR MANOR
Practice Address - State:MD
Practice Address - Zip Code:20722
Practice Address - Country:US
Practice Address - Phone:301-699-7077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program