Healthcare Provider Details

I. General information

NPI: 1831407543
Provider Name (Legal Business Name): CHINYERE N AHANEKU R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1138
US

IV. Provider business mailing address

2242 POWELL AVE
BRONX NY
10462-5104
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-8750
  • Fax: 718-918-8790
Mailing address:
  • Phone: 917-597-8927
  • Fax: 718-918-8790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number453103
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number45103
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: