Provider Demographics
NPI:1538020557
Name:TSOBGNY, LIHOUDEM T
Entity type:Individual
Prefix:
First Name:LIHOUDEM
Middle Name:T
Last Name:TSOBGNY
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 1:8629 ANNAPOLIS RD APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3109
Mailing Address - Country:US
Mailing Address - Phone:571-678-7216
Mailing Address - Fax:
Practice Address - Street 1:8629 ANNAPOLIS RD APT 1
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3109
Practice Address - Country:US
Practice Address - Phone:571-678-7216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide