Healthcare Provider Details

I. General information

NPI: 1780170464
Provider Name (Legal Business Name): MENGING RUPHINA KUH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7734 BENDER RD
HYATTSVILLE MD
20785-4129
US

IV. Provider business mailing address

7734 BENDER RD
HYATTSVILLE MD
20785-4129
US

V. Phone/Fax

Practice location:
  • Phone: 240-704-3780
  • Fax:
Mailing address:
  • Phone: 240-704-3780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA13792
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: