Healthcare Provider Details

I. General information

NPI: 1700791308
Provider Name (Legal Business Name): QUEEN IHECHI ALOZIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E 230TH ST
BRONX NY
10466-4810
US

IV. Provider business mailing address

4114 BRONXWOOD AVE APT 1
BRONX NY
10466-4580
US

V. Phone/Fax

Practice location:
  • Phone: 718-654-5875
  • Fax:
Mailing address:
  • Phone: 347-360-6003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number409101
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: