Healthcare Provider Details

I. General information

NPI: 1255021614
Provider Name (Legal Business Name): MAB GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2023
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 L ST NW STE 500
WASHINGTON DC
20036-4955
US

IV. Provider business mailing address

2001 L ST NW STE 500
WASHINGTON DC
20036-4955
US

V. Phone/Fax

Practice location:
  • Phone: 202-681-9514
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ALLEGRA BURNEY
Title or Position: COFOUNDER
Credential:
Phone: 202-681-9514