Basic Information
Provider Information | |||||||||
NPI: | 1518146299 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | CECILIA SCORAH, RN | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 7910 WOODMONT AVE | ||||||||
Address2: | SUITE 460 | ||||||||
City: | BETHESDA | ||||||||
State: | MD | ||||||||
PostalCode: | 208143002 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3016569520 | ||||||||
FaxNumber: | 3019349321 | ||||||||
Practice Location | |||||||||
Address1: | 7910 WOODMONT AVE | ||||||||
Address2: | SUITE 460 | ||||||||
City: | BETHESDA | ||||||||
State: | MD | ||||||||
PostalCode: | 208143002 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3016569520 | ||||||||
FaxNumber: | 3019349321 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/30/2007 | ||||||||
LastUpdateDate: | 10/30/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | SCORAH | ||||||||
AuthorizedOfficialFirstName: | CECILIA | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
AuthorizedOfficialTelephone: | 3016569520 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | RN | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | R154250 | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Nursing Service Providers | Registered Nurse |   |
No ID Information.