Provider Demographics
NPI:1225478589
Name:LAINJO, EMELDA M
Entity Type:Individual
Prefix:DR
First Name:EMELDA
Middle Name:M
Last Name:LAINJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 STAUNTON AVE SE APT 27
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1146
Mailing Address - Country:US
Mailing Address - Phone:516-304-2322
Mailing Address - Fax:
Practice Address - Street 1:19718 GERMANTOWN RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1204
Practice Address - Country:US
Practice Address - Phone:516-304-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist