MEDICARE: DIDACUS NDAGHE FONDOH

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

General Provider Information

NPI Number	:	1194466961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIDACUS NDAGHE FONDOH

Provider Business Mailing Address
First Line	:	6903 GOOD LUCK RD
Second Line	:
City	:	NEW CARROLLTON
State	:	MD
Zip	:	20784-3620
Country	:	US
Telephone Number	:	240-481-4177
Fax Number	:

Provider Business Practice Location Address
First Line	:	6903 GOOD LUCK RD
Second Line	:
City	:	NEW CARROLLTON
State	:	MD
Zip	:	20784-3620
Country	:	US
Telephone Number	:	240-481-4177
Fax Number	:

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

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	04/05/2022

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Directions to “ DIDACUS NDAGHE FONDOH ” Practice Location

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