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General NPI Number Information
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NPI Number | 1891715280
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Entity Type | Individual
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Provider Name | PHILOMENA NJIOLE UDE MD
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Gender | Female
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17 BRISTOL ST CROSS ROADS JUVENILE DETENTION CENTER KINGS COUNTY
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City | BROOKLYN
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State | NY
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Zip | 11212
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Country | US
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Telephone | 718-495-8160
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Fax |
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Provider Business Mailing Address
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Address Line | 626 RIVERSIDE DR #6P
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City | NEW YORK
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State | NY
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Zip | 10031
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Country | US
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Telephone | 212-234-6592
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 129016
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License Number State | NY
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