Healthcare Provider Details

I. General information

NPI: 1083281752
Provider Name (Legal Business Name): MUSTAPHA NJIE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 VERSAILLES CT
READING PA
19605-7007
US

IV. Provider business mailing address

55 VERSAILLES CT
READING PA
19605-7007
US

V. Phone/Fax

Practice location:
  • Phone: 610-781-9754
  • Fax:
Mailing address:
  • Phone: 484-529-1693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: