Provider Demographics
NPI:1841569381
Name:INIWAN, BABY FE
Entity Type:Individual
Prefix:
First Name:BABY FE
Middle Name:
Last Name:INIWAN
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 1:650 JACKSON ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1424
Mailing Address - Country:US
Mailing Address - Phone:201-737-8012
Mailing Address - Fax:
Practice Address - Street 1:3050 MILITARY RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-1341
Practice Address - Country:US
Practice Address - Phone:201-737-8012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030508225100000X
DCPT5000012225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist