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General NPI Number Information
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NPI Number | 1275748261
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Entity Type | Individual
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Provider Name | MARIAM IHUOMAKANWA GARUBA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 2008 N GAREY AVE
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City | POMONA
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State | CA
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Zip | 91767-2722
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Country | US
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Telephone | 718-245-2310
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Fax |
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Provider Business Mailing Address
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Address Line | 35 JOURNAL SQUARE PLAZA # 486
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City | JERSEY CITY
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State | NJ
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Zip | 07306-2054
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Country | US
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Telephone | 862-902-9798
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Fax | 731-225-8250
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA09789600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 106867
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D0090775
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 268153
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C172191
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License Number State | CA
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