Healthcare Provider Details

I. General information

NPI: 1245676311
Provider Name (Legal Business Name): SYLVIA NGALA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2013
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4290 NIAGARA ROAD, STE 318
COLLEGE MD
20740
US

IV. Provider business mailing address

4290 NIAGARA ROAD SUITE 318
COLLEGE PARK MD
20740
US

V. Phone/Fax

Practice location:
  • Phone: 301-982-6477
  • Fax: 301-982-6488
Mailing address:
  • Phone: 301-982-6477
  • Fax: 301-982-6488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA5520
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: