Healthcare Provider Details

I. General information

NPI: 1316765373
Provider Name (Legal Business Name): JUNE NZILANI MALUKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 CHRISTIANA RD STE 109
NEWARK DE
19713-4248
US

IV. Provider business mailing address

301 SHISLER CT
NEWARK DE
19702-1341
US

V. Phone/Fax

Practice location:
  • Phone: 302-444-8156
  • Fax:
Mailing address:
  • Phone: 973-809-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0012834
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: