Provider Demographics
NPI:1982956801
Name:TABOH, VICTORINE NDZE
Entity Type:Individual
Prefix:
First Name:VICTORINE
Middle Name:NDZE
Last Name:TABOH
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 1:5806 QUINTANA ST
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2135
Mailing Address - Country:US
Mailing Address - Phone:240-593-2888
Mailing Address - Fax:
Practice Address - Street 1:2313 RHODE ISLAND AVENUE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018
Practice Address - Country:US
Practice Address - Phone:202-635-6006
Practice Address - Fax:202-636-1936
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide