Provider Demographics
NPI:1710391784
Name:DEBLASIO, GINA (PA-C)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:DEBLASIO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 F ST NW STE 701
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2762
Mailing Address - Country:US
Mailing Address - Phone:202-293-7618
Mailing Address - Fax:202-775-1772
Practice Address - Street 1:2112 F ST NW STE 701
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2762
Practice Address - Country:US
Practice Address - Phone:202-293-7618
Practice Address - Fax:202-775-1772
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant