Provider Demographics
NPI:1831910231
Name:AJENG, BORIS NKENG
Entity type:Individual
Prefix:
First Name:BORIS
Middle Name:NKENG
Last Name:AJENG
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 1:8400 WOODLAND MANOR DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-1900
Mailing Address - Country:US
Mailing Address - Phone:781-428-5399
Mailing Address - Fax:
Practice Address - Street 1:8400 WOODLAND MANOR DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-1900
Practice Address - Country:US
Practice Address - Phone:781-428-5399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No172V00000XOther Service ProvidersCommunity Health Worker