Provider Demographics
NPI:1861755274
Name:CHOFONG, SYLVIA MAUYIOH (PHARMD)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:MAUYIOH
Last Name:CHOFONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 HERRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1545
Mailing Address - Country:US
Mailing Address - Phone:240-501-9743
Mailing Address - Fax:
Practice Address - Street 1:5700 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-4102
Practice Address - Country:US
Practice Address - Phone:301-952-7539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2021-01-14
Deactivation Date:2020-11-26
Deactivation Code:
Reactivation Date:2021-01-13
Provider Licenses
StateLicense IDTaxonomies
VA0202219300183500000X
374U00000X
MD27549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty