Individual
EDWIN LAISIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1615 KENILWORTH AVE NE, WASHINGTON, DC 20019-2010
(202) 588-8036
Mailing address
1615 KENILWORTH AVE NE, WASHINGTON, DC 20019-2010
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CLEAR
—
DC
Enumeration date
12/05/2017
Last updated
12/05/2017
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