Provider Demographics
NPI:1912665167
Name:AYALA, ROXANA D
Entity Type:Individual
Prefix:MS
First Name:ROXANA
Middle Name:D
Last Name:AYALA
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 1:7521 GREENLEAF RD
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3410
Mailing Address - Country:US
Mailing Address - Phone:240-353-6650
Mailing Address - Fax:
Practice Address - Street 1:2480 16TH ST NW APT 933
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-6711
Practice Address - Country:US
Practice Address - Phone:202-387-0796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty