Provider Demographics
NPI:1619390184
Name:NDUZEM, EUNICE MBAKEM (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:MBAKEM
Last Name:NDUZEM
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:EUNICE
Other - Middle Name:MBAKEM
Other - Last Name:NDUZEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HOME HEALTH AIDE
Mailing Address - Street 1:7777 RIVERDALE RD APT 302
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3937
Mailing Address - Country:US
Mailing Address - Phone:240-280-5522
Mailing Address - Fax:
Practice Address - Street 1:7777 RIVERDALE RD APT 302
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3937
Practice Address - Country:US
Practice Address - Phone:240-280-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10343374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide