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General NPI Number Information
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NPI Number | 1730607904
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Entity Type | Individual
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Provider Name | AKPENE NOVILE AGBEGNINOU
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Gender | Female
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 09/07/2017
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Provider Practice Location Address
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Address Line | 3934 ANGELTON CT
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City | BURTONSVILLE
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State | MD
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Zip | 20866-2055
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Country | US
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Telephone | 301-980-8761
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Fax |
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Provider Business Mailing Address
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Address Line | 7505 CARROLL AVE
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City | TAKOMA PARK
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State | MD
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Zip | 20912-5715
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Country | US
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Telephone | 301-980-8761
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | A3699
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License Number State | MD
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