Provider Demographics
NPI:1568728798
Name:MAINA, JULIUS WACIRA (LPN)
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:WACIRA
Last Name:MAINA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 BRAMBURY DR APT C
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-1825
Mailing Address - Country:US
Mailing Address - Phone:585-919-6503
Mailing Address - Fax:
Practice Address - Street 1:172 BRAMBURY DR APT C
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1825
Practice Address - Country:US
Practice Address - Phone:585-919-6503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309446164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse