Provider Demographics
NPI:1447094214
Name:NUMBISIA, ALIDA NGANDEU
Entity type:Individual
Prefix:
First Name:ALIDA
Middle Name:NGANDEU
Last Name:NUMBISIA
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 1:14103 HAMMERMILL FIELD DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-5829
Mailing Address - Country:US
Mailing Address - Phone:240-932-8715
Mailing Address - Fax:
Practice Address - Street 1:14103 HAMMERMILL FIELD DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-5829
Practice Address - Country:US
Practice Address - Phone:240-932-8715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide