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NPI Code Detail

MEDICARE: MATILDA DJIN NDIFON

MEDICARE: MATILDA DJIN NDIFON
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
1172V00000XCommunity Health WorkerDC
2251S00000XCommunity/Behavioral Health Agency
33747P1801XPersonal Care Attendant
4171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1386354835
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATILDA DJIN NDIFON
Provider Business Mailing Address
First Line : 11548 FEBRUARY CIR APT 304
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-3903
Country : US
Telephone Number : 240-467-8112
Fax Number :
Provider Business Practice Location Address
First Line : 502 KENNEDY ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-3136
Country : US
Telephone Number : 202-313-7283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2022
Last Update Date : 05/13/2026

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