Provider Demographics
NPI:1619310836
Name:NGANKAK, ALBERTINE LM
Entity Type:Individual
Prefix:
First Name:ALBERTINE
Middle Name:LM
Last Name:NGANKAK
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 1:7777 MAPLE AVE
Mailing Address - Street 2:1211
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5639
Mailing Address - Country:US
Mailing Address - Phone:301-455-8419
Mailing Address - Fax:
Practice Address - Street 1:7777 MAPLE AVE
Practice Address - Street 2:1211
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5639
Practice Address - Country:US
Practice Address - Phone:301-455-8419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide