Provider Demographics
NPI:1558077404
Name:GREY, ERNEST CHARLES
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:CHARLES
Last Name:GREY
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 1:3600 ELY PL SE APT 318
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3057
Mailing Address - Country:US
Mailing Address - Phone:202-361-6984
Mailing Address - Fax:
Practice Address - Street 1:3600 ELY PL SE APT 318
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3057
Practice Address - Country:US
Practice Address - Phone:202-361-6984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant