Healthcare Provider Details

I. General information

NPI: 1396337192
Provider Name (Legal Business Name): CATHARINA JESSICA CARVI LY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 10/01/2023
Certification Date: 10/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW STE 600
WASHINGTON DC
20006-1051
US

IV. Provider business mailing address

2021 K ST NW STE 600
WASHINGTON DC
20006-1051
US

V. Phone/Fax

Practice location:
  • Phone: 202-888-8365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9113938
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: