Provider Demographics
NPI:1275307944
Name:TANYA, ATEMNKENG
Entity Type:Individual
Prefix:
First Name:ATEMNKENG
Middle Name:
Last Name:TANYA
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 1:9304 VAUGHN PL
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2440
Mailing Address - Country:US
Mailing Address - Phone:202-280-3156
Mailing Address - Fax:
Practice Address - Street 1:9304 VAUGHN PL
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2440
Practice Address - Country:US
Practice Address - Phone:202-280-3156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator