Provider Demographics
NPI:1285454199
Name:BESONG, HARINE NDIP ESAME
Entity type:Individual
Prefix:
First Name:HARINE
Middle Name:NDIP ESAME
Last Name:BESONG
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 1:61 TIMBER ROCK RD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2267
Mailing Address - Country:US
Mailing Address - Phone:240-994-1013
Mailing Address - Fax:
Practice Address - Street 1:61 TIMBER ROCK RD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-2267
Practice Address - Country:US
Practice Address - Phone:240-994-1013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide