Provider Demographics
NPI:1538713771
Name:MBANGAH, CLAUDIA FRI
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:FRI
Last Name:MBANGAH
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 1:11700 OLD COLUMBIA PIKE APT 1414
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2556
Mailing Address - Country:US
Mailing Address - Phone:240-423-8134
Mailing Address - Fax:
Practice Address - Street 1:1220 12TH ST SE STE G35
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3738
Practice Address - Country:US
Practice Address - Phone:202-544-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14568374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide