Healthcare Provider Details

I. General information

NPI: 1629597745
Provider Name (Legal Business Name): ARMEL NGASSA TENDA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 PENNSYLVANIA AVE SE
WASHINGTON DC
20020-3865
US

IV. Provider business mailing address

6261 64TH AVE APT 5
RIVERDALE MD
20737-2964
US

V. Phone/Fax

Practice location:
  • Phone: 202-894-6811
  • Fax:
Mailing address:
  • Phone: 240-476-4038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA13072
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: