Healthcare Provider Details

I. General information

NPI: 1265775522
Provider Name (Legal Business Name): CHRISTAL LYNN ACHILLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW STE 2300
WASHINGTON DC
20010-2959
US

IV. Provider business mailing address

106 IRVING ST NW STE 2300
WASHINGTON DC
20010-2959
US

V. Phone/Fax

Practice location:
  • Phone: 202-291-6257
  • Fax: 202-726-4926
Mailing address:
  • Phone: 202-291-6257
  • Fax: 202-726-4926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number300841
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: