Healthcare Provider Details

I. General information

NPI: 1982514428
Provider Name (Legal Business Name): YANICK NGOH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1628 MARION BARRY AVE SE
WASHINGTON DC
20020-4706
US

IV. Provider business mailing address

1813 MOUNT PISGAH LN APT 34
SILVER SPRING MD
20903-2156
US

V. Phone/Fax

Practice location:
  • Phone: 202-866-7505
  • Fax:
Mailing address:
  • Phone: 240-459-3937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: