Provider Demographics
NPI:1184409880
Name:BANDOH-FARLEY, GIFTY N
Entity type:Individual
Prefix:
First Name:GIFTY
Middle Name:N
Last Name:BANDOH-FARLEY
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 1:837 FARAWAY CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1831
Mailing Address - Country:US
Mailing Address - Phone:202-258-6847
Mailing Address - Fax:
Practice Address - Street 1:837 FARAWAY CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1831
Practice Address - Country:US
Practice Address - Phone:202-258-6847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator