Healthcare Provider Details

I. General information

NPI: 1972904621
Provider Name (Legal Business Name): LILLIAN NJOKU M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2014
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 GLOVER AVE
NORWALK CT
06850-1345
US

IV. Provider business mailing address

129 GLOVER AVE
NORWALK CT
06850-1345
US

V. Phone/Fax

Practice location:
  • Phone: 203-536-7058
  • Fax:
Mailing address:
  • Phone: 203-536-7058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number045936
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number45936
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: