Healthcare Provider Details

I. General information

NPI: 1649883968
Provider Name (Legal Business Name): WAIRIMU NJIIRI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6735 112TH ST
FOREST HILLS NY
11375-2349
US

IV. Provider business mailing address

25 BEVERLY PKWY
FREEPORT NY
11520-2001
US

V. Phone/Fax

Practice location:
  • Phone: 718-263-0740
  • Fax:
Mailing address:
  • Phone: 516-383-7324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: