Provider Demographics
NPI:1346058500
Name:BIFTU, KENENI
Entity type:Individual
Prefix:
First Name:KENENI
Middle Name:
Last Name:BIFTU
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 1:6414 ELLIOTT PL
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-5008
Mailing Address - Country:US
Mailing Address - Phone:202-438-1357
Mailing Address - Fax:
Practice Address - Street 1:1616 MARION ST NW APT 213
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3473
Practice Address - Country:US
Practice Address - Phone:202-468-4520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant