Healthcare Provider Details

I. General information

NPI: 1881534808
Provider Name (Legal Business Name): CHIDIMA B ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 HENRY ST
FREEPORT NY
11520-3906
US

IV. Provider business mailing address

879 JAYNE PL
NORTH BALDWIN NY
11510-2969
US

V. Phone/Fax

Practice location:
  • Phone: 516-623-9719
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number073715
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: