Provider Demographics
NPI:1780003111
Name:NCUBE, SIBONGILE
Entity type:Individual
Prefix:
First Name:SIBONGILE
Middle Name:
Last Name:NCUBE
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 1:4938 HAMPDEN LN
Mailing Address - Street 2:#178
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2914
Mailing Address - Country:US
Mailing Address - Phone:301-272-5140
Mailing Address - Fax:
Practice Address - Street 1:11900 PARKLAWN DR
Practice Address - Street 2:#160
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2624
Practice Address - Country:US
Practice Address - Phone:301-272-5140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3466P251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care