Provider Demographics
NPI:1710723218
Name:TEFERI, LETAY ASFAW
Entity type:Individual
Prefix:
First Name:LETAY
Middle Name:ASFAW
Last Name:TEFERI
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 1:1535 NORTH FALKLAND LN
Mailing Address - Street 2:APT 333
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3617
Mailing Address - Country:US
Mailing Address - Phone:301-898-6575
Mailing Address - Fax:
Practice Address - Street 1:1535 NORTH FALKLAND LN
Practice Address - Street 2:APT 333
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3617
Practice Address - Country:US
Practice Address - Phone:301-898-6575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200003772374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide