Provider Demographics
NPI:1972100253
Name:NGOMBA, THOMAS MOTANDE
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:MOTANDE
Last Name:NGOMBA
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 1:9102 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2745
Mailing Address - Country:US
Mailing Address - Phone:240-302-4546
Mailing Address - Fax:
Practice Address - Street 1:11517 SEQUOIA LN
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1469
Practice Address - Country:US
Practice Address - Phone:202-369-3199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376K00000XNursing Service Related ProvidersNurse's Aide