Provider Demographics
NPI:1306265194
Name:AYBAR, PEDRO
Entity type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:AYBAR
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 1:7301 NEEDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-1975
Mailing Address - Country:US
Mailing Address - Phone:240-773-9992
Mailing Address - Fax:
Practice Address - Street 1:22830 WHELAN LANE.
Practice Address - Street 2:
Practice Address - City:BOYDS
Practice Address - State:MD
Practice Address - Zip Code:20841
Practice Address - Country:US
Practice Address - Phone:240-773-9992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)