Provider Demographics
NPI:1184097412
Name:TEMBANG, ESTHER BIH I (N/A)
Entity type:Individual
Prefix:MISS
First Name:ESTHER
Middle Name:BIH
Last Name:TEMBANG
Suffix:I
Gender:F
Credentials:N/A
Other - Prefix:MRS
Other - First Name:N/A
Other - Middle Name:
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:6707 COLUMBIA PARK ROAD
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3331
Mailing Address - Country:US
Mailing Address - Phone:240-558-0156
Mailing Address - Fax:
Practice Address - Street 1:6811 W FOREST RD
Practice Address - Street 2:APT 103
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-3331
Practice Address - Country:US
Practice Address - Phone:240-558-0156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 3747P1801X
DCHHA11618374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide