Healthcare Provider Details

I. General information

NPI: 1467228395
Provider Name (Legal Business Name): SYNERGISTIC HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22780 THREE NOTCH RD
LEXINGTON PARK MD
20653
US

IV. Provider business mailing address

PO BOX 5
VALLEY LEE MD
20692-0005
US

V. Phone/Fax

Practice location:
  • Phone: 301-737-0662
  • Fax: 301-737-0675
Mailing address:
  • Phone: 240-925-7997
  • Fax: 833-471-6056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PAMELA A LAIGLE
Title or Position: FAMILY NURSE PRACTITIONER
Credential: FNP-C
Phone: 240-925-7997