Provider Demographics
NPI:1962762823
Name:BEKONDO, EPSE KALIA BERIHE BENSI
Entity type:Individual
Prefix:
First Name:EPSE KALIA BERIHE
Middle Name:BENSI
Last Name:BEKONDO
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 1:1816 IRVING ST NE
Mailing Address - Street 2:APT 306
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2456
Mailing Address - Country:US
Mailing Address - Phone:240-487-8368
Mailing Address - Fax:
Practice Address - Street 1:1816 IRVING ST NE
Practice Address - Street 2:APT 306
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2456
Practice Address - Country:US
Practice Address - Phone:240-487-8368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2562315374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide