MEDICARE: DR. BEDE IKENNA NNOLIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	327537	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154336634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEDE IKENNA NNOLIM MD

Provider Business Mailing Address
First Line	:	953 SOUTHERN BLVD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10459-3428
Country	:	US
Telephone Number	:
Fax Number	:	910-292-2091

Provider Business Practice Location Address
First Line	:	953 SOUTHERN BLVD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10459-3428
Country	:	US
Telephone Number	:	718-589-4541
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/29/2024

Similar Medicare Providers

1013976976 — ODYSSEY HOUSE, INC
Practice Location Address:

953 SOUTHERN BLVD RM 301
BRONX, NY
10459-3428

Practice Phone: 718-860-2994
Practice Fax:

1760684278 — CARE PLUS MEDICAL ASSOCIATES PC
Practice Location Address:

953 SOUTHERN BLVD , SUITE 204
BRONX, NY
10459-3428

Practice Phone: 646-209-7350
Practice Fax:

1548560683 — ASSISTANCE BY IMPROV II, INC
Practice Location Address:

953 SOUTHERN BLVD
BRONX, NY
10459-3428

Practice Phone: 929-263-1242
Practice Fax: 646-401-7420

1598041998 — NYC PODIATRY PC
Practice Location Address:

953 SOUTHERN BLVD , LOBBY
BRONX, NY
10459-3428

Practice Phone: 347-590-2707
Practice Fax: 347-590-2706

1154690386 — SCREEN MEDICAL IMAGING PC
Practice Location Address:

953 SOUTHERN BLVD , LOBBY
BRONX, NY
10459-3428

Practice Phone: 347-590-2707
Practice Fax: 347-590-2706

1235409244 — JSM PHARMACY INC
Practice Location Address:

953 SOUTHERN BLVD
BRONX, NY
10459-3428

Practice Phone: 347-577-5060
Practice Fax: 347-577-5061

Directions to “ DR. BEDE IKENNA NNOLIM MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.