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General NPI Number Information
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NPI Number | 1326960303
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Entity Type | Individual
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Provider Name | TANDRE GONGS
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Gender | Male
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 1700 H ST NE APT 412
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City | WASHINGTON
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State | DC
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Zip | 20002-9129
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Country | US
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Telephone | 202-631-6747
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 MARYLAND AVE NE APT 134W
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City | WASHINGTON
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State | DC
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Zip | 20002-7658
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Country | US
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Telephone | 202-336-9324
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | DC
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