Provider Demographics
NPI:1194125054
Name:LIENDO HERNANDEZ, SAYRA (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:SAYRA
Middle Name:
Last Name:LIENDO HERNANDEZ
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9506 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1816
Mailing Address - Country:US
Mailing Address - Phone:240-353-6913
Mailing Address - Fax:
Practice Address - Street 1:15100 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4602
Practice Address - Country:US
Practice Address - Phone:301-776-5404
Practice Address - Fax:301-776-5460
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12371183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist