Provider Demographics
NPI:1972100253
Name:NGOMBA, THOMAS MOTANDE
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:MOTANDE
Last Name:NGOMBA
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 1:9102 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2745
Mailing Address - Country:US
Mailing Address - Phone:240-302-4546
Mailing Address - Fax:
Practice Address - Street 1:1400 FAIRMONT ST NW APT 408
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-6919
Practice Address - Country:US
Practice Address - Phone:202-369-3199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide