Healthcare Provider Details

I. General information

NPI: 1912683608
Provider Name (Legal Business Name): ALUSIUS NJINGONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6372 STAPLETON CT
FAIRFIELD TOWNSHIP OH
45011-6460
US

IV. Provider business mailing address

6372 STAPLETON CT
FAIRFIELD TOWNSHIP OH
45011-6460
US

V. Phone/Fax

Practice location:
  • Phone: 989-493-3733
  • Fax:
Mailing address:
  • Phone: 989-493-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: