Provider Demographics
NPI:1508405002
Name:CHOFONG, ADELINE NGWEPUH
Entity Type:Individual
Prefix:
First Name:ADELINE
Middle Name:NGWEPUH
Last Name:CHOFONG
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 1:49 HERRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1545
Mailing Address - Country:US
Mailing Address - Phone:240-825-6787
Mailing Address - Fax:
Practice Address - Street 1:49 HERRINGTON DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1545
Practice Address - Country:US
Practice Address - Phone:240-825-6787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14864374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide