Provider Demographics
NPI:1417666942
Name:ACCESS HEALTH FAMILY CLINIC LLC
Entity Type:Organization
Organization Name:ACCESS HEALTH FAMILY CLINIC LLC
Other - Org Name:ACCESS HEALTH FAMILY CLINIC LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASONGTIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NTONGHAWAH
Authorized Official - Suffix:
Authorized Official - Credentials:DNPPMHNP-BCFNP-C
Authorized Official - Phone:202-499-4300
Mailing Address - Street 1:9470 ANNAPOLIS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4048
Mailing Address - Country:US
Mailing Address - Phone:202-499-4300
Mailing Address - Fax:410-424-0862
Practice Address - Street 1:9470 ANNAPOLIS RD STE 101
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4048
Practice Address - Country:US
Practice Address - Phone:202-499-4300
Practice Address - Fax:410-424-0862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty