Provider Demographics
NPI:1295016269
Name:TAYE, REDIET (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REDIET
Middle Name:
Last Name:TAYE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 FLAGLER PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1604
Mailing Address - Country:US
Mailing Address - Phone:202-262-9328
Mailing Address - Fax:
Practice Address - Street 1:1217 22ND ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1203
Practice Address - Country:US
Practice Address - Phone:202-776-9084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18656183500000X
DCPH100000808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist