Provider Demographics
NPI:1154219830
Name:ASONGANYI, MARO ATABONG
Entity type:Individual
Prefix:
First Name:MARO
Middle Name:ATABONG
Last Name:ASONGANYI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13111 LARCHDALE RD APT 11
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1751
Mailing Address - Country:US
Mailing Address - Phone:240-927-8396
Mailing Address - Fax:
Practice Address - Street 1:13111 LARCHDALE RD APT 11
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1751
Practice Address - Country:US
Practice Address - Phone:240-927-8396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide