Provider Demographics
NPI:1821042953
Name:ONYIRIMBA, MAUREEN N (MD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:N
Last Name:ONYIRIMBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3040
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-0040
Mailing Address - Country:US
Mailing Address - Phone:860-426-9440
Mailing Address - Fax:860-426-9646
Practice Address - Street 1:55 MERIDEN AVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-3238
Practice Address - Country:US
Practice Address - Phone:860-426-9440
Practice Address - Fax:860-426-9646
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT038480208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT01157RMedicare UPIN