Provider Demographics
NPI:1225703317
Name:ATONGAJUA, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ATONGAJUA
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 1:2514 SIR MICHAEL PL
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1685
Mailing Address - Country:US
Mailing Address - Phone:240-260-8326
Mailing Address - Fax:
Practice Address - Street 1:2514 SIR MICHAEL PL
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1685
Practice Address - Country:US
Practice Address - Phone:240-260-8326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCNA0000813034Medicaid