Provider Demographics
NPI:1225397839
Name:ESONGNE, CECILIA NTOKO
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:NTOKO
Last Name:ESONGNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9737 MOUNT PISGAH RD
Mailing Address - Street 2:APT 312
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2020
Mailing Address - Country:US
Mailing Address - Phone:256-658-4112
Mailing Address - Fax:
Practice Address - Street 1:9737 MOUNT PISGAH RD
Practice Address - Street 2:APT 312
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2020
Practice Address - Country:US
Practice Address - Phone:256-658-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDE-252-112-641-032374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide