Provider Demographics
NPI:1497087092
Name:MAPONYA, MAMAKIRI
Entity Type:Individual
Prefix:
First Name:MAMAKIRI
Middle Name:
Last Name:MAPONYA
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 1:201 WILLETT AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-4280
Mailing Address - Country:US
Mailing Address - Phone:914-640-0454
Mailing Address - Fax:
Practice Address - Street 1:239 W 238TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2455
Practice Address - Country:US
Practice Address - Phone:347-252-6043
Practice Address - Fax:347-326-8320
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049062183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist