Provider Demographics
NPI:1972265148
Name:HAYAJNEH, RAJA YOUSEF
Entity Type:Individual
Prefix:
First Name:RAJA
Middle Name:YOUSEF
Last Name:HAYAJNEH
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 1:501 W FRANKLIN ST APT 314
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1997
Mailing Address - Country:US
Mailing Address - Phone:443-616-5614
Mailing Address - Fax:
Practice Address - Street 1:2204 N ROLLING RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-1825
Practice Address - Country:US
Practice Address - Phone:410-265-8593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist