Provider Demographics
NPI:1134981004
Name:JULIANA EPSE TANGUFOR, BEZALEFAC NJUKENG
Entity type:Individual
Prefix:
First Name:BEZALEFAC
Middle Name:NJUKENG
Last Name:JULIANA EPSE TANGUFOR
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 1:7831 RIVERDALE RD APT 303
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-4016
Mailing Address - Country:US
Mailing Address - Phone:240-437-8527
Mailing Address - Fax:
Practice Address - Street 1:7831 RIVERDALE RD APT 303
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-4016
Practice Address - Country:US
Practice Address - Phone:240-437-8527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide