Healthcare Provider Details

I. General information

NPI: 1235050154
Provider Name (Legal Business Name): KEREN GYIMAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TOWNSEND AVE BLDG B
BERLIN NJ
08009-9011
US

IV. Provider business mailing address

100 TOWNSEND AVE BLDG B
BERLIN NJ
08009-9011
US

V. Phone/Fax

Practice location:
  • Phone: 609-267-5656
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number37AC00916300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: