Provider Demographics
NPI:1174882724
Name:NGUEKAM, VICTORINE C
Entity type:Individual
Prefix:
First Name:VICTORINE
Middle Name:C
Last Name:NGUEKAM
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 1:1818 METZEROTT RD
Mailing Address - Street 2:#131
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-5163
Mailing Address - Country:US
Mailing Address - Phone:204-704-3505
Mailing Address - Fax:
Practice Address - Street 1:1818 METZEROTT RD
Practice Address - Street 2:#131
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-5163
Practice Address - Country:US
Practice Address - Phone:204-704-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide