Healthcare Provider Details

I. General information

NPI: 1053912816
Provider Name (Legal Business Name): MAGDALEINE ANGUM NJONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SHERIDAN ST APT 410
HYATTSVILLE MD
20783-3207
US

IV. Provider business mailing address

620 SHERIDAN ST APT 410
HYATTSVILLE MD
20783-3207
US

V. Phone/Fax

Practice location:
  • Phone: 301-755-4621
  • Fax:
Mailing address:
  • Phone: 301-755-4621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: