Provider Demographics
NPI:1184462335
Name:MUNONG, LINUS AJECK
Entity type:Individual
Prefix:
First Name:LINUS
Middle Name:AJECK
Last Name:MUNONG
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 1:3406 55TH AVE APT 402
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1021
Mailing Address - Country:US
Mailing Address - Phone:240-991-8612
Mailing Address - Fax:
Practice Address - Street 1:3406 55TH AVE APT 402
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1021
Practice Address - Country:US
Practice Address - Phone:240-991-8612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide