Provider Demographics
NPI:1467163758
Name:LAYDEN, ROSS
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:
Last Name:LAYDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 EMBASSY CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2486
Mailing Address - Country:US
Mailing Address - Phone:757-407-2171
Mailing Address - Fax:
Practice Address - Street 1:1120 20TH ST. NW
Practice Address - Street 2:BLDG. 1 NORTH FLOOR 1
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-998-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program