Provider Demographics
NPI:1518645662
Name:NJUHNGONG, IRENE MBONG
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:MBONG
Last Name:NJUHNGONG
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 1:15116 LAUREL OAKS LN APT 15116
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5509
Mailing Address - Country:US
Mailing Address - Phone:443-454-9579
Mailing Address - Fax:
Practice Address - Street 1:15116 LAUREL OAKS LN APT 15116
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5509
Practice Address - Country:US
Practice Address - Phone:443-454-9579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker