Provider Demographics
NPI:1770844920
Name:NGAPETH, GALIDORE (HHA)
Entity Type:Individual
Prefix:
First Name:GALIDORE
Middle Name:
Last Name:NGAPETH
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13105 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-3727
Mailing Address - Country:US
Mailing Address - Phone:240-565-9438
Mailing Address - Fax:
Practice Address - Street 1:13105 12TH ST
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-3727
Practice Address - Country:US
Practice Address - Phone:240-565-9438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide