Provider Demographics
NPI:1336945351
Name:TAJOH, QUEEN OBENGOCK
Entity type:Individual
Prefix:
First Name:QUEEN
Middle Name:OBENGOCK
Last Name:TAJOH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9528 CAPITAL LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1060
Mailing Address - Country:US
Mailing Address - Phone:301-379-1005
Mailing Address - Fax:
Practice Address - Street 1:9528 CAPITAL LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1060
Practice Address - Country:US
Practice Address - Phone:301-379-1005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide