Healthcare Provider Details
I. General information
NPI: 1013962406
Provider Name (Legal Business Name): AFAMEFUNE ONEJEME M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/23/2006
Last Update Date: 02/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
374 STOCKHOLM ST
BROOKLYN NY
11237-4006
US
IV. Provider business mailing address
374 STOCKHOLM ST
BROOKLYN NY
11237-4006
US
V. Phone/Fax
- Phone: 718-963-6551
- Fax:
- Phone: 718-963-6551
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 192258 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: