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NPI Code Detail

MEDICARE: UDO O IJOMAH

MEDICARE: UDO O IJOMAH
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
1163W00000XRegistered Nurse629852NY

General Provider Information

NPI Number : 1063045060
Entity Type Code : Individual
Provider Name (Legal Business Name) : UDO O IJOMAH
Provider Business Mailing Address
First Line : 833 E 223RD ST
Second Line :
City : BRONX
State : NY
Zip : 10466-4401
Country : US
Telephone Number : 718-581-4082
Fax Number :
Provider Business Practice Location Address
First Line : 3050 WHITE PLAINS RD
Second Line :
City : BRONX
State : NY
Zip : 10467-8124
Country : US
Telephone Number : 718-581-4082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2020
Last Update Date : 02/18/2020

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Directions to “ UDO O IJOMAH ” Practice Location

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