MEDICARE: GILLES YVAN NGATCHA

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
1	374U00000X	Home Health Aide	HHA11316	DC

General Provider Information

NPI Number	:	1053795310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILLES YVAN NGATCHA

Provider Business Mailing Address
First Line	:	11616 STEWART LN APT 401
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2463
Country	:	US
Telephone Number	:	240-708-6310
Fax Number	:

Provider Business Practice Location Address
First Line	:	4516 FORT TOTTEN DR NE
Second Line	:	APT 7
City	:	WASHINGTON
State	:	DC
Zip	:	20011-7523
Country	:	US
Telephone Number	:	240-708-6310
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2015
Last Update Date	:	09/08/2016

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Directions to “ GILLES YVAN NGATCHA ” Practice Location

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