MEDICARE: ISATA BANGURA

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1275123911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISATA BANGURA

Provider Business Mailing Address
First Line	:	5504 GLEN AVE
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-4718
Country	:	US
Telephone Number	:	240-505-0208
Fax Number	:	410-946-2010

Provider Business Practice Location Address
First Line	:	5504 GLEN AVE
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-4718
Country	:	US
Telephone Number	:	202-588-8036
Fax Number	:

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

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	03/12/2026

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Directions to “ ISATA BANGURA ” Practice Location

Language	Start Address	Practice Location

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