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General NPI Number Information
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NPI Number | 1831642172
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Entity Type | Individual
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Provider Name | NENA OLUGU N.P.
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Gender | Female
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 101 NICOLLS RD HSC LEVEL 12, RM 080, DEPARTMENT OF NEUROSURGERY
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City | STONY BROOK
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State | NY
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Zip | 11794-2566
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Country | US
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Telephone | 631-383-7828
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Fax | 631-968-1022
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Provider Business Mailing Address
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Address Line | 101 NICOLLS RD HSC LEVEL 12, RM 080, DEPARTMENT OF NEUROSURGERY
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City | STONY BROOK
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State | NY
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Zip | 11794-2566
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Country | US
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Telephone | 631-383-7828
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Fax | 631-968-1022
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 30-307874
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License Number State | NY
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