Individual
FONJONG GODLOVE TANGWING SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9284 ADELPHI RD, APT 203, HYATTSVILLE, MD 20783-2037
(240) 481-6313
Mailing address
1717 BELLE HAVEN DR APT 201, HYATTSVILLE, MD 20785-4019
(240) 481-6313
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
374U00000X
Home Health Aide
HHA12085
DC
Other
Enumeration date
06/09/2016
Last updated
07/25/2023
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