Provider Demographics
NPI:1386456101
Name:DESERT, HERVINTZ
Entity type:Individual
Prefix:
First Name:HERVINTZ
Middle Name:
Last Name:DESERT
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 1:9802 BRISTOL SQUARE LN APT 302
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-5460
Mailing Address - Country:US
Mailing Address - Phone:781-817-9292
Mailing Address - Fax:
Practice Address - Street 1:1930 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7006
Practice Address - Country:US
Practice Address - Phone:202-450-5822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator