Healthcare Provider Details

I. General information

NPI: 1679326276
Provider Name (Legal Business Name): EMMANUEL UWIZEYE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 SYLVESTER ST
MANCHESTER NH
03102-4648
US

IV. Provider business mailing address

130 SYLVESTER ST
MANCHESTER NH
03102-4648
US

V. Phone/Fax

Practice location:
  • Phone: 603-722-4065
  • Fax:
Mailing address:
  • Phone: 603-722-4065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: