Provider Demographics
NPI:1306180435
Name:NGONG, LOUISE D
Entity Type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:D
Last Name:NGONG
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 1:3015 UPTON DR APT 207
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1938
Mailing Address - Country:US
Mailing Address - Phone:240-316-0773
Mailing Address - Fax:
Practice Address - Street 1:3015 UPTON DRIVE APT 207
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-1938
Practice Address - Country:US
Practice Address - Phone:240-316-0773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health