Provider Demographics
NPI:1841797180
Name:MOUNKENG NDONZOU, SYLPHIDE LAFORET
Entity Type:Individual
Prefix:
First Name:SYLPHIDE LAFORET
Middle Name:
Last Name:MOUNKENG NDONZOU
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 1:8405 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4550
Mailing Address - Country:US
Mailing Address - Phone:240-478-0533
Mailing Address - Fax:
Practice Address - Street 1:8405 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4550
Practice Address - Country:US
Practice Address - Phone:240-478-0533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13565374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide