Provider Demographics
NPI:1104536986
Name:NYABANDO, JAMES BROWN
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BROWN
Last Name:NYABANDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 6TH PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2204
Mailing Address - Country:US
Mailing Address - Phone:202-492-8147
Mailing Address - Fax:
Practice Address - Street 1:4501 6TH PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2204
Practice Address - Country:US
Practice Address - Phone:202-492-8147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator