Active NPI
Ayodelle Syphax
- Pharmacist
- Waldorf, MD
National Provider Identifier
1205128378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19568
- Practice address
- 3300 Western Pkwy
Waldorf, MD 20603-4582 - Phone
- (301) 645-7580
- NPI assigned
- May 9, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19568 | MD | Primary |
Addresses
Primary practice location
3300 Western Pkwy
Waldorf, MD 20603-4582
Mailing address
609 Avis Dr
Upper Marlboro, MD 20774-2283
Phone (240) 468-1292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19568 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304899200000",
"number": "1205128378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 AVIS DR",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207742283",
"telephone_number": "240-468-1292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 WESTERN PKWY",
"city": "WALDORF",
"state": "MD",
"postal_code": "206034582",
"telephone_number": "301-645-7580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYPHAX",
"first_name": "AYODELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-09",
"last_updated": "2011-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "19568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.