Provider Demographics
NPI:1427591569
Name:ACCESS HEALTH AND WELLNESS MEDICAL
Entity Type:Organization
Organization Name:ACCESS HEALTH AND WELLNESS MEDICAL
Other - Org Name:ACCESS HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NP-C
Authorized Official - Prefix:
Authorized Official - First Name:ASONGTIA
Authorized Official - Middle Name:NCHINDIA
Authorized Official - Last Name:NTONGHAWAH
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:301-675-4596
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:301-830-8533
Mailing Address - Fax:
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
Practice Address - Country:US
Practice Address - Phone:301-830-8533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty