Provider Demographics
NPI:1326378936
Name:CYRIL G. HARDY, MDPA
Entity Type:Organization
Organization Name:CYRIL G. HARDY, MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-539-4654
Mailing Address - Street 1:7620 CARROLL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6387
Mailing Address - Country:US
Mailing Address - Phone:301-270-1524
Mailing Address - Fax:301-270-1523
Practice Address - Street 1:7620 CARROLL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6387
Practice Address - Country:US
Practice Address - Phone:301-270-1524
Practice Address - Fax:301-270-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC021160600Medicaid
MD015811900Medicaid
MD015811900Medicaid