Provider Demographics
NPI:1902341316
Name:FUREH, DESMOND SR
Entity Type:Individual
Prefix:
First Name:DESMOND
Middle Name:
Last Name:FUREH
Suffix:SR
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 1:1110 ASPEN STREET NW WASHINGTON DC 20012-2518 APT # 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2518
Mailing Address - Country:US
Mailing Address - Phone:202-823-9240
Mailing Address - Fax:202-450-2125
Practice Address - Street 1:1110 ASPEN ST NW APT 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2518
Practice Address - Country:US
Practice Address - Phone:202-823-9240
Practice Address - Fax:202-450-2125
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12611374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide