Provider Demographics
NPI:1972866531
Name:NDOH, THERESIA
Entity Type:Individual
Prefix:
First Name:THERESIA
Middle Name:
Last Name:NDOH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 METZEROTT RD
Mailing Address - Street 2:APT 205
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-5141
Mailing Address - Country:US
Mailing Address - Phone:513-435-0704
Mailing Address - Fax:
Practice Address - Street 1:1822 METZEROTT RD
Practice Address - Street 2:APT 205
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-5141
Practice Address - Country:US
Practice Address - Phone:513-435-0704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide