Healthcare Provider Details

I. General information

NPI: 1033438023
Provider Name (Legal Business Name): AKIRINJA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2010
Last Update Date: 05/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1669 DEAN ST
BROOKLYN NY
11213-1707
US

IV. Provider business mailing address

6711 242ND ST 3RR
LITTLE NECK NY
11362-1949
US

V. Phone/Fax

Practice location:
  • Phone: 347-248-5643
  • Fax:
Mailing address:
  • Phone: 347-248-5643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. BENET OBINNA UGWU
Title or Position: DIRECTOR
Credential: D.MIN, LMHC, CASAC
Phone: 347-248-5643