Provider Demographics
NPI:1740141175
Name:EBAI, ALVINE NKONGHO
Entity type:Individual
Prefix:
First Name:ALVINE
Middle Name:NKONGHO
Last Name:EBAI
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 1:12006 HUNTERTON ST
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1614
Mailing Address - Country:US
Mailing Address - Phone:510-512-3754
Mailing Address - Fax:
Practice Address - Street 1:12006 HUNTERTON ST
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1614
Practice Address - Country:US
Practice Address - Phone:510-512-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator