Provider Demographics
NPI:1306303581
Name:NJONG, CLEMENT YAH (CN)
Entity type:Individual
Prefix:MR
First Name:CLEMENT
Middle Name:YAH
Last Name:NJONG
Suffix:
Gender:M
Credentials:CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 67TH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1765
Mailing Address - Country:US
Mailing Address - Phone:240-521-9445
Mailing Address - Fax:
Practice Address - Street 1:6021 67TH AVE APT 1
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1765
Practice Address - Country:US
Practice Address - Phone:240-521-9445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14308374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty