Healthcare Provider Details

I. General information

NPI: 1598503005
Provider Name (Legal Business Name): JAMES PUZO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JAMES PUZO SMITH

II. Dates (important events)

Enumeration Date: 07/18/2024
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 UNION ST NE FL 7
WASHINGTON DC
20002-7042
US

IV. Provider business mailing address

1255 UNION ST NE FL 7
WASHINGTON DC
20002-7042
US

V. Phone/Fax

Practice location:
  • Phone: 202-630-0203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGPC200001754
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: