Provider Demographics
NPI:1356151393
Name:NDI, TINONG
Entity type:Individual
Prefix:MR
First Name:TINONG
Middle Name:
Last Name:NDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TINONG
Other - Middle Name:
Other - Last Name:NDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11505 DUCKETTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-9708
Mailing Address - Country:US
Mailing Address - Phone:240-615-5462
Mailing Address - Fax:
Practice Address - Street 1:11505 DUCKETTOWN RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-9708
Practice Address - Country:US
Practice Address - Phone:240-615-5462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator