Provider Demographics
NPI:1326885583
Name:BENNETT, RHENA SULLANO
Entity type:Individual
Prefix:
First Name:RHENA
Middle Name:SULLANO
Last Name:BENNETT
Suffix:
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 1:5002 SINOPE WAY
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1109
Mailing Address - Country:US
Mailing Address - Phone:702-931-5504
Mailing Address - Fax:
Practice Address - Street 1:619 H ST SW APT 103
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-2735
Practice Address - Country:US
Practice Address - Phone:202-270-4648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant