MEDICARE: BARAKA KWIZERA SENZIRA DPM

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	213E00000X	Podiatrist	SC006394	PA

General Provider Information

NPI Number	:	1225393911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARAKA KWIZERA SENZIRA DPM

Provider Business Mailing Address
First Line	:	1900 BRIDGE ST
Second Line	:
City	:	NEW CUMBERLAND
State	:	PA
Zip	:	17070-1127
Country	:	US
Telephone Number	:	717-921-7083
Fax Number	:	717-842-2345

Provider Business Practice Location Address
First Line	:	1900 BRIDGE ST
Second Line	:
City	:	NEW CUMBERLAND
State	:	PA
Zip	:	17070-1127
Country	:	US
Telephone Number	:	717-921-7083
Fax Number	:	717-842-2345

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

Provider Enumeration Date	:	07/09/2012
Last Update Date	:	06/11/2023

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