Individual
ETIENDEM G NZEFOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7509 TAYLOR ST, HYATTSVILLE, MD 20784-6319
(240) 354-5859
Mailing address
7509 TAYLOR ST, HYATTSVILLE, MD 20784-6319
(240) 354-5859
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
DC
374U00000X
Home Health Aide
—
—
Other
Enumeration date
04/23/2012
Last updated
09/05/2023
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