Basic Information
| Provider Information | |||||||||
| NPI: | 1952487647 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PERFECTLY FEMALE WOMEN HEALTH CARE | ||||||||
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| OtherOrganizationName: | EVELYN S FELLUCA, MD | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1860 TOWN CENTER DR | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | RESTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 20190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037960200 | ||||||||
| FaxNumber: | 7037961690 | ||||||||
| Practice Location | |||||||||
| Address1: | 1860 TOWN CENTER DR STE 110 | ||||||||
| Address2: | |||||||||
| City: | RESTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201905898 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037960200 | ||||||||
| FaxNumber: | 7037961690 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2006 | ||||||||
| LastUpdateDate: | 05/24/2019 | ||||||||
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| AuthorizedOfficialLastName: | FELLUCA | ||||||||
| AuthorizedOfficialFirstName: | EVELYN | ||||||||
| AuthorizedOfficialMiddleName: | SYLVIA | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7037960200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.