Provider Demographics
NPI:1700285038
Name:NGUFUA, EUGINE NKEMAKA
Entity Type:Individual
Prefix:MR
First Name:EUGINE
Middle Name:NKEMAKA
Last Name:NGUFUA
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 1:3407 DODGE PARK RD APT 304
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2017
Mailing Address - Country:US
Mailing Address - Phone:202-758-7313
Mailing Address - Fax:
Practice Address - Street 1:3407 DODGE PARK RD APT 304
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2017
Practice Address - Country:US
Practice Address - Phone:202-758-7313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAHI10335374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide