Provider Demographics
NPI:1588170609
Name:LEMA, EMMANUEL JUNIOR BOBGA
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:JUNIOR BOBGA
Last Name:LEMA
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 1:1123 IVY CLUB LN APT 1241
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4531
Mailing Address - Country:US
Mailing Address - Phone:240-766-9387
Mailing Address - Fax:
Practice Address - Street 1:1123 IVY CLUB LN APT 1241
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4531
Practice Address - Country:US
Practice Address - Phone:240-766-9387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13250374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide