Provider Demographics
NPI:1376002394
Name:NGWA, PERRY-LYEV
Entity Type:Individual
Prefix:
First Name:PERRY-LYEV
Middle Name:
Last Name:NGWA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6856 EASTERN AVE NW STE 310
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2170
Mailing Address - Country:US
Mailing Address - Phone:202-722-1234
Mailing Address - Fax:202-722-1220
Practice Address - Street 1:6856 EASTERN AVE NW STE 310
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2170
Practice Address - Country:US
Practice Address - Phone:202-722-1234
Practice Address - Fax:202-722-1220
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14336374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide