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General NPI Number Information
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NPI Number | 1821630369
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Entity Type | Individual
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Provider Name | HALIMATTU MARIAM FODAY-KAKPA FNP
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Gender | Female
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Dates
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Enumeration Date | 10/16/2019
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 1371 SEABURY AVE
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City | BRONX
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State | NY
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Zip | 10461
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Country | US
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Telephone | 718-294-6200
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Fax | 718-294-6859
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Provider Business Mailing Address
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Address Line | 1371 SEABURY AVE
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City | BRONX
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State | NY
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Zip | 10461-3629
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Country | US
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Telephone | 718-294-6200
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Fax | 718-294-6859
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F343609
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License Number State | NY
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