Provider Demographics
NPI:1689939209
Name:NTUMNGIA, RENE
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:NTUMNGIA
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 1:7700 HANOVER PKWY
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2637
Mailing Address - Country:US
Mailing Address - Phone:240-890-0988
Mailing Address - Fax:
Practice Address - Street 1:7700 HANOVER PKWY
Practice Address - Street 2:APT304
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2637
Practice Address - Country:US
Practice Address - Phone:240-890-0988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide