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NPI Code Detail

MEDICARE: ATABONGOJONG GRACE

MEDICARE: ATABONGOJONG GRACE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health AideHHA200003335DC

General Provider Information

NPI Number : 1023887700
Entity Type Code : Individual
Provider Name (Legal Business Name) : ATABONGOJONG GRACE
Provider Business Mailing Address
First Line : 6426 TIFFANY CT
Second Line :
City : LANHAM
State : MD
Zip : 20706-3541
Country : US
Telephone Number : 301-543-7252
Fax Number :
Provider Business Practice Location Address
First Line : 6426 TIFFANY CT
Second Line :
City : LANHAM
State : MD
Zip : 20706-3541
Country : US
Telephone Number : 301-543-7252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2023
Last Update Date : 12/22/2023

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Directions to “ ATABONGOJONG GRACE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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