Healthcare Provider Details

I. General information

NPI: 1255671434
Provider Name (Legal Business Name): ABONG NJONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2013
Last Update Date: 02/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2506 QUEENS CHAPEL RD APT 303
HYATTSVILLE MD
20782
US

IV. Provider business mailing address

2506 QUEENS CHAPEL RD APT 303
HYATTSVILLE MD
20782
US

V. Phone/Fax

Practice location:
  • Phone: 438-995-6156
  • Fax:
Mailing address:
  • Phone: 438-995-6156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: