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General NPI Number Information
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NPI Number | 1891069357
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Entity Type | Individual
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Provider Name | MAUREEN CHUKWUMUANYA AGOHA NP
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Gender | Female
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Dates
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Enumeration Date | 03/01/2012
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Last Update Date | 10/18/2013
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Provider Practice Location Address
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Address Line | 266 BRYANT AVE APT A PADWE OFFICE
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City | WHITE PLAINS
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State | NY
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Zip | 10605-2110
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Country | US
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Telephone | 845-499-5033
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Fax | 914-948-8032
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Provider Business Mailing Address
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Address Line | 266 BRYANT AVE APT A PADWE OFFICE
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City | WHITE PLAINS
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State | NY
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Zip | 10605-2110
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Country | US
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Telephone | 845-499-5033
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Fax | 914-948-8032
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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 | 336234
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License Number State | NY
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