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General NPI Number Information
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NPI Number | 1790649853
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Entity Type | Individual
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Provider Name | LIFIO LYONGA
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Gender | Male
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 8311 DEER RUN CT
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City | SEVERN
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State | MD
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Zip | 21144-2519
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Country | US
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Telephone | 774-253-5453
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Fax |
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Provider Business Mailing Address
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Address Line | 8311 DEER RUN CT
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City | SEVERN
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State | MD
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Zip | 21144-2519
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Country | US
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Telephone | 774-253-5453
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | HHA200005655
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License Number State | DC
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