Healthcare Provider Details

I. General information

NPI: 1316867302
Provider Name (Legal Business Name): LYNE PAYO FODJA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11395 COLUMBIA PIKE APT D12
SILVER SPRING MD
20904-2518
US

IV. Provider business mailing address

11395 COLUMBIA PIKE APT D12
SILVER SPRING MD
20904-2518
US

V. Phone/Fax

Practice location:
  • Phone: 202-795-0055
  • Fax:
Mailing address:
  • Phone: 202-795-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberA00216498
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: