Provider Demographics
NPI:1114152485
Name:NDUKA, PATIENCE GRACE (PT)
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:GRACE
Last Name:NDUKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PATIENCE
Other - Middle Name:
Other - Last Name:NDUKA, ONUOHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:17902 GEORGIA AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:240-774-0222
Mailing Address - Fax:240-774-0223
Practice Address - Street 1:7500 HANOVER PKWY
Practice Address - Street 2:STE, 103
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-446-1644
Practice Address - Fax:301-446-1647
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22871225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist