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NPI Code Detail

MEDICARE: MARTHE CLARISSE NGO DJON EPSE NIBA

MEDICARE:   MARTHE CLARISSE  NGO DJON EPSE NIBA
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 Aide

General Provider Information

NPI Number : 1306479977
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHE CLARISSE NGO DJON EPSE NIBA
Provider Business Mailing Address
First Line : 3025 ONTARIO RD NW APT B1
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-6035
Country : US
Telephone Number : 240-618-7287
Fax Number :
Provider Business Practice Location Address
First Line : 3025 ONTARIO RD NW APT B1
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-6035
Country : US
Telephone Number : 240-618-7287
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2020
Last Update Date : 02/21/2020

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Directions to “ MARTHE CLARISSE NGO DJON EPSE NIBA ” Practice Location

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