Healthcare Provider Details

I. General information

NPI: 1972914430
Provider Name (Legal Business Name): ALYSSA N SMALL LAYNE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2014
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOWARD UNIVERSITY HOSPITAL TOWER
WASHINGTON DC
20060-4903
US

IV. Provider business mailing address

1221 MERCANTILE LN FL 4
UPPER MARLBORO MD
20774-5374
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-4164
  • Fax:
Mailing address:
  • Phone: 301-618-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD047547
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number17076
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number98786
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: