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Individual

NESTOR MBORONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7613 RIVERDALE RD APT 112, NEW CARROLLTON, MD 20784-3736
(240) 714-8935
Mailing address
7613 RIVERDALE RD APT 112, NEW CARROLLTON, MD 20784-3736
(240) 714-8935

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN1008727
DC
374U00000X
Home Health Aide
HHA11923
DC

Other

Enumeration date
04/01/2016
Last updated
01/15/2019
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