Provider Demographics
NPI:1386090116
Name:TROH, NENKERWON
Entity type:Individual
Prefix:
First Name:NENKERWON
Middle Name:
Last Name:TROH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 240601
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-0011
Mailing Address - Country:US
Mailing Address - Phone:857-919-9535
Mailing Address - Fax:857-203-9456
Practice Address - Street 1:26 CORBET ST APT 1
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-4217
Practice Address - Country:US
Practice Address - Phone:857-919-9535
Practice Address - Fax:857-203-9456
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health