Provider Demographics
NPI:1629408299
Name:NGAMEDJEU, THERESE
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:NGAMEDJEU
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 1:6000 42ND AVE
Mailing Address - Street 2:APT 311
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-1564
Mailing Address - Country:US
Mailing Address - Phone:301-366-6831
Mailing Address - Fax:
Practice Address - Street 1:6000 42ND AVE
Practice Address - Street 2:APT 311
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-1564
Practice Address - Country:US
Practice Address - Phone:301-366-6831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide