Provider Demographics
NPI:1770269870
Name:NANJEH SYLVANUS, ETONGWE
Entity type:Individual
Prefix:
First Name:ETONGWE
Middle Name:
Last Name:NANJEH SYLVANUS
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ETONGWE
Other - Middle Name:
Other - Last Name:NANJEH SYLVANUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9745 GOOD LUCK RD APT 9
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3322
Mailing Address - Country:US
Mailing Address - Phone:240-615-6859
Mailing Address - Fax:
Practice Address - Street 1:9745 GOOD LUCK RD APT 9
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3322
Practice Address - Country:US
Practice Address - Phone:240-615-6859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health