Provider Demographics
NPI:1992353189
Name:GRACE PERINATAL ASSOCIATES, INC.
Entity type:Organization
Organization Name:GRACE PERINATAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UGOCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:AKOMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-346-0964
Mailing Address - Street 1:2296 OPITZ BLVD STE 440
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3355
Mailing Address - Country:US
Mailing Address - Phone:703-346-0964
Mailing Address - Fax:
Practice Address - Street 1:2296 OPITZ BLVD STE 440
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3355
Practice Address - Country:US
Practice Address - Phone:703-346-0964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty