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General NPI Number Information
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NPI Number | 1124333570
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Entity Type | Individual
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Provider Name | CHINONYE O EDEH NP
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Gender | Female
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 760 BROADWAY
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City | BROOKLYN
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State | NY
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Zip | 11206-5317
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Country | US
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Telephone | 718-963-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 6 ALMOND ST
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-4103
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Country | US
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Telephone | 718-790-2883
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 614592
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F403228-01
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License Number State | NY
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