Provider Demographics
NPI:1932834439
Name:PETERKIN, ALYIAH ARMINA
Entity type:Individual
Prefix:
First Name:ALYIAH
Middle Name:ARMINA
Last Name:PETERKIN
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 1:397 LITTLE NECK RD BLDG 3300 SUITE 220
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452
Mailing Address - Country:US
Mailing Address - Phone:757-717-8681
Mailing Address - Fax:757-802-7929
Practice Address - Street 1:397 LITTLE NECK RD BLDG 3300 SUITE 220
Practice Address - Street 2:STE
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452
Practice Address - Country:US
Practice Address - Phone:757-717-8681
Practice Address - Fax:757-802-7949
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-231520251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health