Provider Demographics
NPI:1457677544
Name:PERRY, RALPH G
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:G
Last Name:PERRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5969 E LIVINGSTON AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-2907
Mailing Address - Country:US
Mailing Address - Phone:614-863-6950
Mailing Address - Fax:614-863-6957
Practice Address - Street 1:5969 E LIVINGSTON AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-2907
Practice Address - Country:US
Practice Address - Phone:614-863-6950
Practice Address - Fax:614-863-6957
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1398813163WH0200X, 164W00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide