Provider Demographics
NPI:1578169827
Name:JANGMIA, RICHARD VOMA
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:VOMA
Last Name:JANGMIA
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 1:1836 METZEROTT RD APT 1103
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3448
Mailing Address - Country:US
Mailing Address - Phone:240-429-2980
Mailing Address - Fax:
Practice Address - Street 1:1836 METZEROTT RD APT 1103
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-3448
Practice Address - Country:US
Practice Address - Phone:240-429-2980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCHHA12345Medicaid