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General NPI Number Information
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NPI Number | 1427558840
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Entity Type | Organization
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Legal Business Name | WGA HEALTHCARE
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Dates
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Enumeration Date | 02/13/2018
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Last Update Date | 03/20/2018
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Provider Practice Location Address
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Address Line | 44 BERRY ST APT 205
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City | SOMERSET
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State | NJ
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Zip | 08873-3542
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Country | US
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Telephone | 302-314-5186
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Fax |
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Provider Business Mailing Address
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Address Line | 4023 KENNETT PIKE STE 568
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City | WILMINGTON
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State | DE
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Zip | 19807-2018
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Country | US
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Telephone | 302-314-5186
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CECILIA KIHUNGI
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Credential |
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Telephone | 302-314-5186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 38MC00678700
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License Number State | NJ
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