1952578049 NPI number — MR. NABIE YAHAYA DANCAY-BANGURA

Table of content: MR. NABIE YAHAYA DANCAY-BANGURA (NPI 1952578049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952578049 NPI number — MR. NABIE YAHAYA DANCAY-BANGURA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANCAY-BANGURA
Provider First Name:
NABIE
Provider Middle Name:
YAHAYA
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DANCAY-BANGURA
Provider Other First Name:
NABIE
Provider Other Middle Name:
YAHAYA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPH
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1952578049
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4102 TUDOR RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UPPER MARLBORO
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20772-9374
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-780-5326
Provider Business Mailing Address Fax Number:
202-675-2607

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 CONSTITUTION AVE NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20002-6058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-546-5700
Provider Business Practice Location Address Fax Number:
202-675-2607
Provider Enumeration Date:
05/08/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PHA3174 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)