Provider Demographics
NPI:1376041491
Name:NGENYI, CARINE BEZA
Entity Type:Individual
Prefix:
First Name:CARINE
Middle Name:BEZA
Last Name:NGENYI
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 1:9111 SPRINGHILL LN APT 202
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-5256
Mailing Address - Country:US
Mailing Address - Phone:571-343-6986
Mailing Address - Fax:
Practice Address - Street 1:9111 SPRINGHILL LN APT 202
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-5256
Practice Address - Country:US
Practice Address - Phone:571-343-6986
Practice Address - Fax:571-343-6986
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC13427374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide