Organization
BONI MEDICAL & PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH NGALE (PRESIDENT)
(301) 512-0726
Entity
Organization
Contact information
Practice address
4030 BLACKBURN LN, BURTONSVILLE, MD 20866-1168
(240) 722-6733
Mailing address
4030 BLACKBURN LN, BURTONSVILLE, MD 20866-1168
(240) 722-6733
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
04/10/2024
Last updated
05/30/2024
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