Healthcare Provider Details

I. General information

NPI: 1659206613
Provider Name (Legal Business Name): GAZUNTITE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3803 T ST NW
WASHINGTON DC
20007-2122
US

IV. Provider business mailing address

3803 T ST NW
WASHINGTON DC
20007-2122
US

V. Phone/Fax

Practice location:
  • Phone: 202-664-3039
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JOHN HARRISON
Title or Position: CEO
Credential:
Phone: 202-361-9000