Provider Demographics
NPI:1215420617
Name:NGASSA, ERNEST NGESI (PHARMACIST)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:NGESI
Last Name:NGASSA
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7709 RIVERDALE RD APT 103
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3941
Mailing Address - Country:US
Mailing Address - Phone:202-704-0233
Mailing Address - Fax:
Practice Address - Street 1:5210 INDIAN HEAD HWY
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-2048
Practice Address - Country:US
Practice Address - Phone:301-633-4132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist