Provider Demographics
NPI:1619314929
Name:NGOYE, BELTINE
Entity Type:Individual
Prefix:
First Name:BELTINE
Middle Name:
Last Name:NGOYE
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 1:401 PEMBERTON ST
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1944
Mailing Address - Country:US
Mailing Address - Phone:240-486-5353
Mailing Address - Fax:
Practice Address - Street 1:401 PEMBERTON ST
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1944
Practice Address - Country:US
Practice Address - Phone:240-486-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA2044374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide