MEDICARE: PIERRO AJONG AJONG

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	171M00000X	Case Manager/Care Coordinator
2	374U00000X	Home Health Aide	HHA200005980	DC

General Provider Information

NPI Number	:	1306694575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIERRO AJONG AJONG

Provider Business Mailing Address
First Line	:	5704 85TH AVE
Second Line	:
City	:	NEW CARROLLTON
State	:	MD
Zip	:	20784-2927
Country	:	US
Telephone Number	:	202-931-9417
Fax Number	:

Provider Business Practice Location Address
First Line	:	5704 85TH AVE
Second Line	:
City	:	NEW CARROLLTON
State	:	MD
Zip	:	20784-2927
Country	:	US
Telephone Number	:	202-931-9417
Fax Number	:

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

Provider Enumeration Date	:	05/10/2024
Last Update Date	:	02/02/2026

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