MEDICARE: ANDREAS NJI MBAH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	DI47473	FL
2	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	CQP105990	NY

General Provider Information

NPI Number	:	1194368795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREAS NJI MBAH

Provider Business Mailing Address
First Line	:	601 N CONGRESS AVE STE 110B
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-4626
Country	:	US
Telephone Number	:	347-988-6436
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 N CONGRESS AVE STE 110B
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-4626
Country	:	US
Telephone Number	:	347-988-6436
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2019
Last Update Date	:	10/16/2025

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