Provider Demographics
NPI:1982234555
Name:NGOH, COLLINS N
Entity Type:Individual
Prefix:
First Name:COLLINS
Middle Name:N
Last Name:NGOH
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 1:1220 12TH ST SE STE G35
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3738
Mailing Address - Country:US
Mailing Address - Phone:202-544-8090
Mailing Address - Fax:202-544-8091
Practice Address - Street 1:6839B RIVERDALE RD APT B2
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-3688
Practice Address - Country:US
Practice Address - Phone:301-454-9387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14868374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide