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NPI Code Detail

MEDICARE: CONSTANCE NGOZI MOFUNANYA NP

MEDICARE: CONSTANCE NGOZI MOFUNANYA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374T00000XReligious Nonmedical Nursing PersonnelF381447NY

General Provider Information

NPI Number : 1033294210
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONSTANCE NGOZI MOFUNANYA NP
Provider Business Mailing Address
First Line : 171 GLENBROOK PKWY
Second Line :
City : ENGLEWOOD
State : NJ
Zip : 07631-2105
Country : US
Telephone Number : 201-647-7815
Fax Number :
Provider Business Practice Location Address
First Line : 1225 GERARD AVE
Second Line : MORRISANIA
City : BRONX
State : NY
Zip : 10452-8001
Country : US
Telephone Number : 718-960-2893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/08/2007

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