Provider Demographics
NPI:1952535288
Name:ANYAEGBU, MOSES E (MSW)
Entity Type:Individual
Prefix:MR
First Name:MOSES
Middle Name:E
Last Name:ANYAEGBU
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 WATERTON DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-4918
Mailing Address - Country:US
Mailing Address - Phone:267-304-0981
Mailing Address - Fax:
Practice Address - Street 1:42 WATERTON DR
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-4918
Practice Address - Country:US
Practice Address - Phone:267-304-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst