Angelique Lynette Vailes
Specialist in Hyattsville, MD. Individual provider (NPI-1).
NPI number1124593686
StatusActive
Last updated in NPPESSep 7, 2026
Details
- NPI
- 1124593686
- Entity type
- Individual (NPI-1)
- Name
- Ms. Angelique Lynette Vailes
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 10, 2018
- Certification date
- Sep 7, 2026
- Last updated
- Sep 7, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 118206 | MD | Yes |
Practice location
3510 65th Ave Unit 10fHyattsville, MD 20784-2464
Phone 240-375-1670
Mailing address
3510 65th Ave Unit 10fHyattsville, MD 20784-2464
Phone 240-375-1670
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 8 Specialist providers in Hyattsville · All 2,789 providers in Hyattsville
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