Healthcare Provider Details

I. General information

NPI: 1447026075
Provider Name (Legal Business Name): ANNETTE NJOROGE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

7254 FRITZ RD
FORT WAYNE IN
46818-9412
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-4242
  • Fax:
Mailing address:
  • Phone: 260-255-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0016090
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: