Healthcare Provider Details

I. General information

NPI: 1366938987
Provider Name (Legal Business Name): PATIENCE OPARAJI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 MEMORIAL HWY STE 2-1
NEW ROCHELLE NY
10801-5640
US

IV. Provider business mailing address

175 MEMORIAL HWY STE 2-1
NEW ROCHELLE NY
10801-5640
US

V. Phone/Fax

Practice location:
  • Phone: 914-235-7530
  • Fax: 914-235-8470
Mailing address:
  • Phone: 914-235-7530
  • Fax: 914-235-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number9946664
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: