Healthcare Provider Details

I. General information

NPI: 1700127461
Provider Name (Legal Business Name): DANIEL JUWEL NGUNGOH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7635 LAYTONIA DR
GAITHERSBURG MD
20877-3855
US

IV. Provider business mailing address

7635 LAYTONIA DR
GAITHERSBURG MD
20877-3855
US

V. Phone/Fax

Practice location:
  • Phone: 301-792-0424
  • Fax:
Mailing address:
  • Phone: 301-792-0424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberAHI 103620
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: