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Individual

DERICK TEWAN NGU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4605 N CAPITOL ST NE, WASHINGTON, DC 20011-6723
(202) 751-8237
Mailing address
4605 N CAPITOL ST NE, WASHINGTON, DC 20011-6723

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA10006
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
70780361
DC
Enumeration date
11/20/2013
Last updated
11/20/2013
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