Provider Demographics
NPI:1225308117
Name:NDIFON, AWU B
Entity Type:Individual
Prefix:
First Name:AWU
Middle Name:B
Last Name:NDIFON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BEATRICE
Other - Middle Name:A
Other - Last Name:NDIFON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7600 GEORGIA AVE NW
Mailing Address - Street 2:323
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1616
Mailing Address - Country:US
Mailing Address - Phone:202-723-3060
Mailing Address - Fax:202-723-3065
Practice Address - Street 1:7600 GEORGIA AVE NW
Practice Address - Street 2:323
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1616
Practice Address - Country:US
Practice Address - Phone:202-723-3060
Practice Address - Fax:202-723-3065
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide