Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PT872138 | DC |
NPI | 1033637541 |
---|---|
Provider Name | Ms. Brianna Bachelle Eliades |
First Address | Washington, DC 20037 |
Second Address | Washington, DC 20037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2017 |
Last Update Date | 05/09/2017 |