Provider Demographics
NPI:1760275465
Name:NDAKWE, THOMAS TITO
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:TITO
Last Name:NDAKWE
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 1:4415 NICOLE DR STE G
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4357
Mailing Address - Country:US
Mailing Address - Phone:301-306-2020
Mailing Address - Fax:
Practice Address - Street 1:4415 NICOLE DR STE G
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4357
Practice Address - Country:US
Practice Address - Phone:301-306-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200004867374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide