Provider Demographics
NPI:1891202826
Name:NGATSI, GHISLAIN TOMBOU (HHA)
Entity Type:Individual
Prefix:MR
First Name:GHISLAIN
Middle Name:TOMBOU
Last Name:NGATSI
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:MR
Other - First Name:GHISLAIN
Other - Middle Name:TOMBOU
Other - Last Name:NGATSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HHA
Mailing Address - Street 1:12412 CECILY CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5648
Mailing Address - Country:US
Mailing Address - Phone:240-486-8772
Mailing Address - Fax:
Practice Address - Street 1:12412 CECILY CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-5648
Practice Address - Country:US
Practice Address - Phone:240-486-8772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13126374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide