Healthcare Provider Details

I. General information

NPI: 1629982772
Provider Name (Legal Business Name): CLEMENT ANDOH TANKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7611 NEWBURG DR
LANHAM MD
20706-4610
US

IV. Provider business mailing address

7611 NEWBURG DR
LANHAM MD
20706-4610
US

V. Phone/Fax

Practice location:
  • Phone: 240-990-1306
  • Fax:
Mailing address:
  • Phone: 240-990-1306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: