Provider Demographics
NPI:1336403138
Name:TANGA, ERNEST NJI
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:NJI
Last Name:TANGA
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 1:9875 GOOD LUCK RD
Mailing Address - Street 2:APT 10
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3204
Mailing Address - Country:US
Mailing Address - Phone:240-280-6170
Mailing Address - Fax:
Practice Address - Street 1:9875 GOOD LUCK RD
Practice Address - Street 2:APT 10
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3204
Practice Address - Country:US
Practice Address - Phone:240-280-6170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide