Healthcare Provider Details

I. General information

NPI: 1487973368
Provider Name (Legal Business Name): MRS. LENYA GREGORY-PERKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4415 14TH ST NW
WASHINGTON DC
20011-7019
US

IV. Provider business mailing address

4415 14TH ST NW
WASHINGTON DC
20011-7019
US

V. Phone/Fax

Practice location:
  • Phone: 202-722-4545
  • Fax: 202-722-4517
Mailing address:
  • Phone: 202-722-4545
  • Fax: 202-722-4517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number1744P300X
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License NumberDCM2726
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: