Provider Demographics
NPI:1417764895
Name:TCHOUMENI E NZOUDJI, SANDRINE
Entity type:Individual
Prefix:
First Name:SANDRINE
Middle Name:
Last Name:TCHOUMENI E NZOUDJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3079 SCHUBERT DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6837
Mailing Address - Country:US
Mailing Address - Phone:240-481-1133
Mailing Address - Fax:
Practice Address - Street 1:3079 SCHUBERT DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-6837
Practice Address - Country:US
Practice Address - Phone:240-481-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide