Provider Demographics
NPI:1982822185
Name:EGUJIE, TONY
Entity Type:Individual
Prefix:MR
First Name:TONY
Middle Name:
Last Name:EGUJIE
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 1:13714 KORNBLUM AVE
Mailing Address - Street 2:APT. 9
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-9501
Mailing Address - Country:US
Mailing Address - Phone:310-242-1840
Mailing Address - Fax:
Practice Address - Street 1:13714 KORNBLUM AVE
Practice Address - Street 2:APT. 9
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-9501
Practice Address - Country:US
Practice Address - Phone:310-242-1840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor