Active NPI
Eyob Belay Woldetnsae
- Pharmacist
- Hyattsville, MD
National Provider Identifier
1861712572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17811
- Practice address
- 1823 E West Hwy
Hyattsville, MD 20783-3032 - Phone
- (301) 439-7100
- Fax
- (301) 439-7134
- NPI assigned
- Jun 3, 2010
- Last updated
- Jun 3, 2010
- Sex
- Male
- 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 | 17811 | MD | Primary |
Addresses
Primary practice location
1823 E West Hwy
Hyattsville, MD 20783-3032
Mailing address
1517 Regent Manor CT
Silver Spring, MD 20904-2209
Phone (240) 401-0728
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 |
|---|---|---|---|
| 17811 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275523200000",
"number": "1861712572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1517 REGENT MANOR CT",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209042209",
"telephone_number": "240-401-0728",
"fax_number": "301-622-0226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1823 E WEST HWY",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207833032",
"telephone_number": "301-439-7100",
"fax_number": "301-439-7134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLDETNSAE",
"first_name": "EYOB",
"middle_name": "BELAY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-03",
"last_updated": "2010-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "17811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyattsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.