Provider Demographics
NPI:1932086691
Name:MANJUSUNG, EUGINE
Entity type:Individual
Prefix:
First Name:EUGINE
Middle Name:
Last Name:MANJUSUNG
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 1:9865 GOOD LUCK RD APT 39865
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3203
Mailing Address - Country:US
Mailing Address - Phone:204-977-0060
Mailing Address - Fax:
Practice Address - Street 1:9865 GOOD LUCK RD APT 39865
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3203
Practice Address - Country:US
Practice Address - Phone:204-977-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator