Provider Demographics
NPI:1710720735
Name:NDEAGA, JULIUS NDE
Entity type:Individual
Prefix:
First Name:JULIUS
Middle Name:NDE
Last Name:NDEAGA
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 1:8432 FIELDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4778
Mailing Address - Country:US
Mailing Address - Phone:240-424-1516
Mailing Address - Fax:
Practice Address - Street 1:8432 FIELDSTONE WAY
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4778
Practice Address - Country:US
Practice Address - Phone:240-424-1516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty