Provider Demographics
NPI:1609127323
Name:TANGIE, JOHN FUNWI (HHA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FUNWI
Last Name:TANGIE
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 OGLETHORPE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-1540
Mailing Address - Country:US
Mailing Address - Phone:240-464-7925
Mailing Address - Fax:
Practice Address - Street 1:4213 OGLETHORPE ST APT 4
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-1540
Practice Address - Country:US
Practice Address - Phone:240-464-7925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker