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Individual

ERIC TENDONGAFAC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4309 RUSSELL AVE, MOUNT RAINIER, MD 20712-1452
(240) 472-7801
Mailing address
4309 RUSSELL AVE, MOUNT RAINIER, MD 20712-1452

Taxonomy

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

Other

Enumeration date
11/01/2024
Last updated
11/01/2024
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