Provider Demographics
NPI:1912266776
Name:ZELIFAC, EMMANUEL ASONG (HHA)
Entity Type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:ASONG
Last Name:ZELIFAC
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:MR
Other - First Name:EMMANUEL
Other - Middle Name:ZELIFAC
Other - Last Name:ASONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:740 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5953
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:740 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5953
Practice Address - Country:US
Practice Address - Phone:571-276-0650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide