Provider Demographics
NPI:1902228208
Name:ALLEYNE, ESTERLYN B (PHLEB)
Entity Type:Individual
Prefix:
First Name:ESTERLYN
Middle Name:B
Last Name:ALLEYNE
Suffix:
Gender:F
Credentials:PHLEB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4839 BOWLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-7051
Mailing Address - Country:US
Mailing Address - Phone:410-361-1091
Mailing Address - Fax:
Practice Address - Street 1:4839 BOWLAND AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-7051
Practice Address - Country:US
Practice Address - Phone:410-361-1091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD172V00000X, 374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
No172V00000XOther Service ProvidersCommunity Health Worker