Provider Demographics
NPI:1942039474
Name:MOSTOFA, DEBORAH GALVAO
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:GALVAO
Last Name:MOSTOFA
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 1:812 CAPITOL SQUARE PL SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2419
Mailing Address - Country:US
Mailing Address - Phone:202-819-7575
Mailing Address - Fax:
Practice Address - Street 1:812 CAPITOL SQUARE PL SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-2419
Practice Address - Country:US
Practice Address - Phone:202-819-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula