Provider Demographics
NPI:1972499218
Name:FORBANJONG, NDE
Entity type:Individual
Prefix:
First Name:NDE
Middle Name:
Last Name:FORBANJONG
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 1:1485 SURREY RUN CT
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-4497
Mailing Address - Country:US
Mailing Address - Phone:567-868-2003
Mailing Address - Fax:
Practice Address - Street 1:1485 SURREY RUN CT
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-4497
Practice Address - Country:US
Practice Address - Phone:567-868-2003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN723396163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical