Provider Demographics
NPI:1942550660
Name:IRACKS, DREYON
Entity Type:Individual
Prefix:
First Name:DREYON
Middle Name:
Last Name:IRACKS
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 1:4256 E CAPITOL ST NE APT 3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-4484
Mailing Address - Country:US
Mailing Address - Phone:202-500-6930
Mailing Address - Fax:
Practice Address - Street 1:1818 NEW YORK AVE NE STE 115
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1851
Practice Address - Country:US
Practice Address - Phone:202-269-2401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide