Provider Demographics
NPI:1992246664
Name:NJUME, ELVIRA
Entity type:Individual
Prefix:
First Name:ELVIRA
Middle Name:
Last Name:NJUME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 KEER AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-1709
Mailing Address - Country:US
Mailing Address - Phone:862-224-2614
Mailing Address - Fax:
Practice Address - Street 1:179 KEER AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-1709
Practice Address - Country:US
Practice Address - Phone:862-224-2614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2019-07-19
Deactivation Date:2019-06-19
Deactivation Code:
Reactivation Date:2019-07-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician