Provider Demographics
NPI:1922826148
Name:TANGA, ERNEST
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:
Last Name:TANGA
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 1:8523 SHORTHILLS DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4608
Mailing Address - Country:US
Mailing Address - Phone:240-784-3351
Mailing Address - Fax:
Practice Address - Street 1:8523 SHORTHILLS DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4608
Practice Address - Country:US
Practice Address - Phone:240-784-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator