Healthcare Provider Details

I. General information

NPI: 1528911997
Provider Name (Legal Business Name): SURZINE NGUIAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUE VENISE

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4451 TELFAIR BLVD APT 6113
CAMP SPRINGS MD
20746-5272
US

IV. Provider business mailing address

4451 TELFAIR BLVD APT 6113
CAMP SPRINGS MD
20746-5272
US

V. Phone/Fax

Practice location:
  • Phone: 760-677-3499
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: