Provider Demographics
NPI:1851712491
Name:NDZE, LAWRENCE NSOTAKA
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:NSOTAKA
Last Name:NDZE
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 1:7010 HANOVER PKWY
Mailing Address - Street 2:#D2
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2043
Mailing Address - Country:US
Mailing Address - Phone:301-613-1946
Mailing Address - Fax:
Practice Address - Street 1:7010 HANOVER PKWY
Practice Address - Street 2:#D2
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2043
Practice Address - Country:US
Practice Address - Phone:301-613-1946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-29
Last Update Date:2013-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA8429374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide