Provider Demographics
NPI:1649049768
Name:NGANDU, ALINE GLADIS
Entity type:Individual
Prefix:
First Name:ALINE
Middle Name:GLADIS
Last Name:NGANDU
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 1:1181 ELLOWAY PL
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-6471
Mailing Address - Country:US
Mailing Address - Phone:616-329-3577
Mailing Address - Fax:
Practice Address - Street 1:1181 ELLOWAY PL
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-6471
Practice Address - Country:US
Practice Address - Phone:616-329-3577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care