Healthcare Provider Details

I. General information

NPI: 1164340097
Provider Name (Legal Business Name): MS. ONEESHA NYDIA FORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 JARRET PL
BRONX NY
10461-2606
US

IV. Provider business mailing address

3329 FENTON AVE PH
BRONX NY
10469-2805
US

V. Phone/Fax

Practice location:
  • Phone: 718-681-9300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: