Healthcare Provider Details

I. General information

NPI: 1821471285
Provider Name (Legal Business Name): ROBERT TEACHEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 07/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 H ST NE
WASHINGTON DC
20002-5034
US

IV. Provider business mailing address

1411 H ST NE
WASHINGTON DC
20002-5034
US

V. Phone/Fax

Practice location:
  • Phone: 202-795-9097
  • Fax:
Mailing address:
  • Phone: 202-795-9097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: