Provider Demographics
NPI:1275242430
Name:NGWA, EMMANUEL JITZI
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:JITZI
Last Name:NGWA
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 1:2489 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-1300
Mailing Address - Country:US
Mailing Address - Phone:919-641-4364
Mailing Address - Fax:
Practice Address - Street 1:2489 WILSON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-1300
Practice Address - Country:US
Practice Address - Phone:919-641-4364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty