Provider Demographics
NPI:1851264147
Name:NGIGI, ANDREW MAMBO
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MAMBO
Last Name:NGIGI
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 1:12045 W TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-7208
Mailing Address - Country:US
Mailing Address - Phone:480-679-0313
Mailing Address - Fax:
Practice Address - Street 1:12045 W TAYLOR ST
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-7208
Practice Address - Country:US
Practice Address - Phone:480-679-0313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty