Provider Demographics
NPI:1942551817
Name:BANYONG, MANKA AWAH (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:
First Name:MANKA
Middle Name:AWAH
Last Name:BANYONG
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7715 RIVERDALE RD
Mailing Address - Street 2:APT 202
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3943
Mailing Address - Country:US
Mailing Address - Phone:240-432-7339
Mailing Address - Fax:
Practice Address - Street 1:7715 RIVERDALE RD
Practice Address - Street 2:APT 202
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3943
Practice Address - Country:US
Practice Address - Phone:240-432-7339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health