Healthcare Provider Details

I. General information

NPI: 1215641006
Provider Name (Legal Business Name): MARCUS M NJOROGEH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 COURTHOUSE LN STE 9
CHELMSFORD MA
01824-1721
US

IV. Provider business mailing address

3 COURTHOUSE LN STE 9
CHELMSFORD MA
01824-1721
US

V. Phone/Fax

Practice location:
  • Phone: 978-905-0233
  • Fax:
Mailing address:
  • Phone: 978-905-0233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: