MEDICARE: CHINENYE NWOGWUGWU

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	163W00000X	Registered Nurse	506828	NY

General Provider Information

NPI Number	:	1174776777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHINENYE NWOGWUGWU

Provider Business Mailing Address
First Line	:	665 THWAITES PL
Second Line	:	APT 2P
City	:	BRONX
State	:	NY
Zip	:	10467-7947
Country	:	US
Telephone Number	:	347-427-7753
Fax Number	:

Provider Business Practice Location Address
First Line	:	665 THWAITES PL
Second Line	:	APT 2P
City	:	BRONX
State	:	NY
Zip	:	10467-7947
Country	:	US
Telephone Number	:	347-427-7753
Fax Number	:

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

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	10/28/2008

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