Provider Demographics
NPI:1578062386
Name:ASONGANYI, EMMANUEL NJIWUNG
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:NJIWUNG
Last Name:ASONGANYI
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 1:6810 E MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-2217
Mailing Address - Country:US
Mailing Address - Phone:614-957-0311
Mailing Address - Fax:614-957-0344
Practice Address - Street 1:96 CRESTVIEW LN
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-6308
Practice Address - Country:US
Practice Address - Phone:781-346-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide