Healthcare Provider Details

I. General information

NPI: 1669087094
Provider Name (Legal Business Name): SYLVIA HABER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 09/11/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11801 FINGERBOARD RD STE 6
MONROVIA MD
21770-9030
US

IV. Provider business mailing address

8215 GLEN HEATHER DR
FREDERICK MD
21702-9495
US

V. Phone/Fax

Practice location:
  • Phone: 301-882-7370
  • Fax:
Mailing address:
  • Phone: 240-315-7160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10039
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: