Healthcare Provider Details

I. General information

NPI: 1295717312
Provider Name (Legal Business Name): DREW E PERMUT, PHD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 19TH ST NW SUITE 800
WASHINGTON DC
20036-2407
US

IV. Provider business mailing address

1234 19TH ST NW SUITE 800
WASHINGTON DC
20036-2407
US

V. Phone/Fax

Practice location:
  • Phone: 202-775-9590
  • Fax: 202-775-0287
Mailing address:
  • Phone: 202-775-9590
  • Fax: 202-775-0287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1064
License Number StateDC

VIII. Authorized Official

Name: DR. DREW E PERMUT
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 202-775-9590