MEDICARE: VICTOR NJOMENY NTCHONGWANG

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0041350	OH

General Provider Information

NPI Number	:	1861343923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR NJOMENY NTCHONGWANG

Provider Business Mailing Address
First Line	:	30 SEVERANCE CIR
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1531
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 SEVERANCE CIR
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1531
Country	:	US
Telephone Number	:	614-953-4584
Fax Number	:

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	03/23/2026

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