Provider Demographics
NPI:1215745450
Name:TABENG, VILAND
Entity type:Individual
Prefix:
First Name:VILAND
Middle Name:
Last Name:TABENG
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 1:5759 PITTSFORD DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-5791
Mailing Address - Country:US
Mailing Address - Phone:240-224-5634
Mailing Address - Fax:
Practice Address - Street 1:5759 PITTSFORD DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-5791
Practice Address - Country:US
Practice Address - Phone:240-224-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No253Z00000XAgenciesIn Home Supportive Care