| Eyerosie Llc | |
|
4500 Forbes Blvd Ste 200 Lanham MD 20706-6316 | |
| (443) 741-8920 | |
| (443) 203-2617 |
| Full Name | Eyerosie Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4500 Forbes Blvd Ste 200, Lanham, Maryland |
| Authorized Official Name and Position | Siddiqui Hernandez (OWNER) |
| Authorized Official Contact | 4437418920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eyerosie Llc 4500 Forbes Blvd Ste 200 Lanham MD 20706-6316 Ph: (443) 741-8920 | Eyerosie Llc 4500 Forbes Blvd Ste 200 Lanham MD 20706-6316 Ph: (443) 741-8920 |
| NPI Number | 1922537067 |
|---|---|
| Provider Enumeration Date | 06/11/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922537067 | NPI | - | NPPES |
| R205786 | Other | MD | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | R205786 (Maryland) | Primary |
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