Healthcare Provider Details

I. General information

NPI: 1952578049
Provider Name (Legal Business Name): MR. NABIE YAHAYA DANCAY-BANGURA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NABIE YAHAYA DANCAY-BANGURA RPH

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CONSTITUTION AVE NE
WASHINGTON DC
20002-6058
US

IV. Provider business mailing address

4102 TUDOR RD
UPPER MARLBORO MD
20772-9374
US

V. Phone/Fax

Practice location:
  • Phone: 202-546-5700
  • Fax: 202-675-2607
Mailing address:
  • Phone: 301-780-5326
  • Fax: 202-675-2607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA3174
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: