Basic Information
| Provider Information | |||||||||
| NPI: | 1992736540 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCORAH | ||||||||
| FirstName: | CECILIA | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
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| 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: | 07/05/2006 | ||||||||
| LastUpdateDate: | 10/30/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | R154250 | MD | Y | Nursing Service Providers | Registered Nurse |
ID Information
| ID | Type | State | Issuer | Description | M577 | 01 | DC | BLUE CROSS | OTHER | 594639 | 01 | MD | MAMSI/UNITED HEALTHCARE | OTHER |