Provider Demographics
NPI:1538879119
Name:ELSAID, TARIQ N
Entity type:Individual
Prefix:
First Name:TARIQ
Middle Name:N
Last Name:ELSAID
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 1:811 4TH ST NW UNIT 519
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-4914
Mailing Address - Country:US
Mailing Address - Phone:814-876-0769
Mailing Address - Fax:
Practice Address - Street 1:811 4TH ST NW UNIT 519
Practice Address - Street 2:
Practice Address - City:WASHINGTON DC
Practice Address - State:DC
Practice Address - Zip Code:20001
Practice Address - Country:US
Practice Address - Phone:814-876-0769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851115651104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker