Most Relevant Information
Provider Data
| NPI Number: | 1003015223 |
| Provider Name: | NICHOLAS WAIGANJO LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | LP41792 |
Most Important Dates
| Enumeration Date: | 07/17/2007 |
| Last Updated: | 07/17/2007 |
Provider Practice Location
2250 HICKORY RD
SUITE 240
PLYMOUTH MEETING
PA
194621047
Practice Location Phone/Fax
| Phone: | 6108341122 |
| Fax: |
Provider Mailing Location
2245 PENTLAND DR
APT. B
BALTIMORE
MD
212347212
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |