Provider Demographics
NPI:1760266217
Name:NDIFOR TASHI, ANDASON ROMANOUS
Entity Type:Individual
Prefix:
First Name:ANDASON ROMANOUS
Middle Name:
Last Name:NDIFOR TASHI
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 1:7808 HUBBLE DR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2493
Mailing Address - Country:US
Mailing Address - Phone:301-905-7948
Mailing Address - Fax:
Practice Address - Street 1:7808 HUBBLE DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2493
Practice Address - Country:US
Practice Address - Phone:301-905-7948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8434104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker