Provider Demographics
NPI:1144589755
Name:AYENG, PAMELA A
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:A
Last Name:AYENG
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 1:3805 ERNST DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3208
Mailing Address - Country:US
Mailing Address - Phone:240-755-1095
Mailing Address - Fax:
Practice Address - Street 1:3805 ERNST DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3208
Practice Address - Country:US
Practice Address - Phone:240-755-1095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide