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General NPI Number Information
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NPI Number | 1043546781
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Entity Type | Individual
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Provider Name | NGOZI JULIA UDEH M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2009
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Last Update Date | 11/01/2009
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Provider Practice Location Address
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Address Line | 8900 VAN WYCK EXPY
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City | JAMAICA
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State | NY
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Zip | 11418-2832
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Country | US
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Telephone | 718-206-6070
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Fax |
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Provider Business Mailing Address
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Address Line | 17844 146TH TER
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City | JAMAICA
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State | NY
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Zip | 11434-5329
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Country | US
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Telephone | 347-446-4103
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 255198-1
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License Number State | NY
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