Provider Demographics
NPI:1689136822
Name:BERINYUY-JAMES, VIVIAN KILA
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:KILA
Last Name:BERINYUY-JAMES
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 1:6495 NEW HAMPSHIRE AVE STE B130
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3245
Mailing Address - Country:US
Mailing Address - Phone:301-494-2146
Mailing Address - Fax:301-494-2143
Practice Address - Street 1:6495 NEW HAMPSHIRE AVE STE B130
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3245
Practice Address - Country:US
Practice Address - Phone:301-494-2146
Practice Address - Fax:301-494-2143
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21252183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist