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General NPI Number Information
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NPI Number | 1972100253
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Entity Type | Individual
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Provider Name | THOMAS MOTANDE NGOMBA
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Gender | Male
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 11517 SEQUOIA LN
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City | BELTSVILLE
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State | MD
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Zip | 20705-1469
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Country | US
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Telephone | 202-369-3199
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Fax |
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Provider Business Mailing Address
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Address Line | 9102 7TH ST
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City | LANHAM
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State | MD
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Zip | 20706-2745
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Country | US
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Telephone | 240-302-4546
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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 |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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