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General NPI Number Information
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NPI Number | 1720705452
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Entity Type | Individual
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Provider Name | NO GIVEN NAME NJUME MBENDE MBONG
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Gender | Male
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 7735 RIVERDALE RD
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-3902
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Country | US
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Telephone | 240-885-1060
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Fax |
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Provider Business Mailing Address
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Address Line | 7735 RIVERDALE RD
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-3902
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Country | US
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Telephone | 240-885-1060
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | HHA200002113
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License Number State | DC
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