Provider Demographics
NPI:1942042395
Name:ENGOWEI, VICTORINE
Entity type:Individual
Prefix:
First Name:VICTORINE
Middle Name:
Last Name:ENGOWEI
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 1:2411 SHADYSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4813
Mailing Address - Country:US
Mailing Address - Phone:240-917-6762
Mailing Address - Fax:
Practice Address - Street 1:2411 SHADYSIDE AVE
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4813
Practice Address - Country:US
Practice Address - Phone:240-917-6762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide