Provider Demographics
NPI:1669282075
Name:NKONGDEM, MBONGUE ALVINE BELLEH
Entity type:Individual
Prefix:
First Name:MBONGUE
Middle Name:ALVINE BELLEH
Last Name:NKONGDEM
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 1:7775 RIVERDALE RD APT 102
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3935
Mailing Address - Country:US
Mailing Address - Phone:202-893-4488
Mailing Address - Fax:
Practice Address - Street 1:7775 RIVERDALE RD APT 102
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3935
Practice Address - Country:US
Practice Address - Phone:202-893-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide