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General NPI Number Information
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NPI Number | 1659678142
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Entity Type | Organization
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Legal Business Name | DIVINE LOVE MEDICAL SERVICES PC
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Dates
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Enumeration Date | 02/17/2011
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 9502 FOSTER AVE
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City | BROOKLYN
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State | NY
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Zip | 11236-2016
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Country | US
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Telephone | 347-425-1849
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Fax | 347-240-1505
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Provider Business Mailing Address
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Address Line | 9502 FOSTER AVE
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City | BROOKLYN
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State | NY
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Zip | 11236-2016
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Country | US
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Telephone | 347-425-1849
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Fax | 347-240-1505
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | AMAKA CHRISTINE UZOIGWE
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Credential | MD
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Telephone | 347-425-1849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 243076
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License Number State | NY
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