Provider Demographics
NPI:1578076691
Name:NGAMEN, SIMPLICE
Entity Type:Individual
Prefix:
First Name:SIMPLICE
Middle Name:
Last Name:NGAMEN
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 1:3404 DEAN DR APT A1
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-1206
Mailing Address - Country:US
Mailing Address - Phone:240-476-2081
Mailing Address - Fax:
Practice Address - Street 1:3404 DEAN DR APT A1
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-1206
Practice Address - Country:US
Practice Address - Phone:240-476-2081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-11
Last Update Date:2017-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide