Provider Demographics
NPI:1487181277
Name:JUDITH LEKUNGA EPSE DZEKEWONG, FOYABO
Entity Type:Individual
Prefix:
First Name:FOYABO
Middle Name:
Last Name:JUDITH LEKUNGA EPSE DZEKEWONG
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 1:3411 DODGE PARK RD APT 101
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2025
Mailing Address - Country:US
Mailing Address - Phone:240-413-6198
Mailing Address - Fax:
Practice Address - Street 1:3411 DODGE PARK RD APT 101
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-2025
Practice Address - Country:US
Practice Address - Phone:240-413-6198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide