Provider Demographics
NPI:1841852340
Name:MBONGEH, CLAUDIA NYONKA
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:NYONKA
Last Name:MBONGEH
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 1:6713 TERRA ALTA DR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3747
Mailing Address - Country:US
Mailing Address - Phone:240-584-2024
Mailing Address - Fax:
Practice Address - Street 1:6713 TERRA ALTA DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3747
Practice Address - Country:US
Practice Address - Phone:240-584-2024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14541374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide