Provider Demographics
NPI:1669015541
Name:EKOKOBE, NDEMAFIA
Entity Type:Individual
Prefix:
First Name:NDEMAFIA
Middle Name:
Last Name:EKOKOBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 MAHNAZ CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20774-3000
Mailing Address - Country:US
Mailing Address - Phone:202-677-9145
Mailing Address - Fax:
Practice Address - Street 1:3604 MAHNAZ CT
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:MD
Practice Address - Zip Code:20774-3000
Practice Address - Country:US
Practice Address - Phone:202-677-9145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide