Provider Demographics
NPI:1558616698
Name:NYAMBI, WILLIAM W
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:W
Last Name:NYAMBI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21504 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-1841
Mailing Address - Country:US
Mailing Address - Phone:301-379-0359
Mailing Address - Fax:
Practice Address - Street 1:21504 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:BROOKEVILLE
Practice Address - State:MD
Practice Address - Zip Code:20833-1841
Practice Address - Country:US
Practice Address - Phone:301-379-0359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-15
Last Update Date:2012-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide