Provider Demographics
NPI:1043601420
Name:GWEKWERERE, GADZIRO
Entity Type:Individual
Prefix:
First Name:GADZIRO
Middle Name:
Last Name:GWEKWERERE
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 1:1564 LINCOLN PL
Mailing Address - Street 2:APT 2 R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-5183
Mailing Address - Country:US
Mailing Address - Phone:347-208-7244
Mailing Address - Fax:
Practice Address - Street 1:1564 LINCOLN PL
Practice Address - Street 2:APT 2 R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-5183
Practice Address - Country:US
Practice Address - Phone:347-208-7244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst