Healthcare Provider Details

I. General information

NPI: 1497553267
Provider Name (Legal Business Name): GABRIEL ALUMBAT ATEMNKENG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 POWHATAN ST
NEW CARROLLTON MD
20784-3532
US

IV. Provider business mailing address

7900 POWHATAN ST
NEW CARROLLTON MD
20784-3532
US

V. Phone/Fax

Practice location:
  • Phone: 240-424-7060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number200004749
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: