Provider Demographics
NPI:1366933657
Name:THOMPSON-TAYLOR, LLOYDEJZAH EBONI
Entity type:Individual
Prefix:
First Name:LLOYDEJZAH EBONI
Middle Name:
Last Name:THOMPSON-TAYLOR
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 1:3101 SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1047
Mailing Address - Country:US
Mailing Address - Phone:240-755-2232
Mailing Address - Fax:
Practice Address - Street 1:3101 SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1047
Practice Address - Country:US
Practice Address - Phone:240-755-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant