Provider Demographics
NPI:1922807031
Name:ASONGALEM, SHAKY NJUNKENG
Entity type:Individual
Prefix:
First Name:SHAKY
Middle Name:NJUNKENG
Last Name:ASONGALEM
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 1:3611 SCRUGGS PL
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5407
Mailing Address - Country:US
Mailing Address - Phone:240-886-6700
Mailing Address - Fax:
Practice Address - Street 1:3611 SCRUGGS PL
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:MD
Practice Address - Zip Code:20774-5407
Practice Address - Country:US
Practice Address - Phone:240-886-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide