Provider Demographics
NPI:1639361140
Name:EJINDU, PASTOR PIUS
Entity Type:Individual
Prefix:
First Name:PASTOR
Middle Name:PIUS
Last Name:EJINDU
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 1:16 THOMPSON CIR
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-2403
Mailing Address - Country:US
Mailing Address - Phone:781-593-9224
Mailing Address - Fax:781-593-9224
Practice Address - Street 1:16 THOMPSON CIR
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-2403
Practice Address - Country:US
Practice Address - Phone:781-593-9224
Practice Address - Fax:781-593-9224
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health