Provider Demographics
NPI:1710247929
Name:ALEAH EPSE MBENDEKE, CARINE KOJIA
Entity Type:Individual
Prefix:
First Name:CARINE
Middle Name:KOJIA
Last Name:ALEAH EPSE MBENDEKE
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 1:7765 RIVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3928
Mailing Address - Country:US
Mailing Address - Phone:240-701-1820
Mailing Address - Fax:
Practice Address - Street 1:7765 RIVERDALE RD
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3928
Practice Address - Country:US
Practice Address - Phone:240-701-1820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide