Provider Demographics
NPI:1992065437
Name:NTUNGWE, CORLINS PALLE (HOME HEALTH AIDE)
Entity type:Individual
Prefix:MR
First Name:CORLINS
Middle Name:PALLE
Last Name:NTUNGWE
Suffix:
Gender:M
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8915 WOODBURN CT
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3520
Mailing Address - Country:US
Mailing Address - Phone:301-358-1765
Mailing Address - Fax:
Practice Address - Street 1:8915 WOODBURN CT
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3520
Practice Address - Country:US
Practice Address - Phone:301-358-1765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide