Provider Demographics
NPI:1649755745
Name:NAYBOR, MIRIAN SILVA (CPHT)
Entity Type:Individual
Prefix:
First Name:MIRIAN
Middle Name:SILVA
Last Name:NAYBOR
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:MIRIAN
Other - Middle Name:CRISTINA
Other - Last Name:DA SILVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5614 FLAG RUN DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-2725
Mailing Address - Country:US
Mailing Address - Phone:301-448-6801
Mailing Address - Fax:
Practice Address - Street 1:5614 FLAG RUN DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-2725
Practice Address - Country:US
Practice Address - Phone:301-448-6801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA30049861183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician