Healthcare Provider Details

I. General information

NPI: 1659710457
Provider Name (Legal Business Name): PATRICIA IFEOMA UWECHUE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2013
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 CLEVELAND ST
VALLEY STREAM NY
11580-6003
US

IV. Provider business mailing address

PO BOX 30247
ELMONT NY
11003-0247
US

V. Phone/Fax

Practice location:
  • Phone: 516-823-0739
  • Fax:
Mailing address:
  • Phone: 516-205-0511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF408733-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number669721
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: