Provider Demographics
NPI:1649535436
Name:NTAH, ROMAULD ABANKE
Entity type:Individual
Prefix:
First Name:ROMAULD
Middle Name:ABANKE
Last Name:NTAH
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 1:6529 LANDOVER RD
Mailing Address - Street 2:APT T2
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1429
Mailing Address - Country:US
Mailing Address - Phone:202-706-1169
Mailing Address - Fax:
Practice Address - Street 1:6529 LANDOVER RD
Practice Address - Street 2:APT T2
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1429
Practice Address - Country:US
Practice Address - Phone:202-706-1169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide