Healthcare Provider Details

I. General information

NPI: 1891604526
Provider Name (Legal Business Name): TSELOT YEBELTAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3830 GEORGIA AVE NW
WASHINGTON DC
20011-5841
US

IV. Provider business mailing address

9702 ADMIRALTY DR
SILVER SPRING MD
20910-1401
US

V. Phone/Fax

Practice location:
  • Phone: 202-722-4067
  • Fax:
Mailing address:
  • Phone: 240-437-7497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH200005344
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: