Provider Demographics
NPI:1578828810
Name:PERRAS, NICOLE NGUYEN (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:NGUYEN
Last Name:PERRAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2115 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2265
Mailing Address - Country:US
Mailing Address - Phone:240-428-4834
Mailing Address - Fax:202-944-5404
Practice Address - Street 1:2115 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2265
Practice Address - Country:US
Practice Address - Phone:202-944-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0419752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry