Provider Demographics
NPI:1033474333
Name:MUNJANJA, NYARADZO PRISCA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:NYARADZO
Middle Name:PRISCA
Last Name:MUNJANJA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:10 FERRY ST STE 302
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5081
Mailing Address - Country:US
Mailing Address - Phone:603-526-4635
Mailing Address - Fax:603-526-8283
Practice Address - Street 1:1400 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1105
Practice Address - Country:US
Practice Address - Phone:617-714-4534
Practice Address - Fax:617-714-4962
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY015712363A00000X
IL085007410363A00000X
MAPA9579363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant