Healthcare Provider Details

I. General information

NPI: 1992956288
Provider Name (Legal Business Name): ANGELA VIMBAYI KADENHE-CHIWESHE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA VIMBAYI KADENHE M.D

II. Dates (important events)

Enumeration Date: 10/04/2008
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

9 ROCKY RAPIDS RD
STAMFORD CT
06903-3131
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-2599
  • Fax: 212-746-3884
Mailing address:
  • Phone: 646-483-0965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number247813
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number0101280079
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: