Healthcare Provider Details

I. General information

NPI: 1467878934
Provider Name (Legal Business Name): MR. ERNEST NGOH TENDON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2014
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3416 DODGE PARK RD # ABT101
LANDOVER MD
20785-2035
US

IV. Provider business mailing address

3416 DODGE PARK RD # ABT101
LANDOVER MD
20785-2035
US

V. Phone/Fax

Practice location:
  • Phone: 240-467-4037
  • Fax:
Mailing address:
  • Phone: 240-467-4037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA10322
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberHHA10322
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: