Provider Demographics
NPI:1972371037
Name:NGANKOU NJOMO, ALEX
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:NGANKOU NJOMO
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 1:2915 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2683
Mailing Address - Country:US
Mailing Address - Phone:240-703-0017
Mailing Address - Fax:
Practice Address - Street 1:2915 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-2683
Practice Address - Country:US
Practice Address - Phone:240-703-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator