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NPI Code Detail

MEDICARE: VICTOR AZUBIKE AMOBI CRNP-PMH

MEDICARE: VICTOR AZUBIKE AMOBI CRNP-PMH
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
1163WP0808XPsychiatric/Mental Health Registered Nurse679575CA
2163WP0809XAdult Psychiatric/Mental Health Registered NurseR178048MD
3363LP0808XPsychiatric/Mental Health Nurse Practitioner402802NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1679575OTHERCANURSING BOARD

General Provider Information

NPI Number : 1356532386
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTOR AZUBIKE AMOBI CRNP-PMH
Provider Business Mailing Address
First Line : 2929 WOODLAND PARK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77082-2687
Country : US
Telephone Number : 713-589-4122
Fax Number :
Provider Business Practice Location Address
First Line : 169 W 133RD ST
Second Line :
City : NEW YORK
State : NY
Zip : 10030-3301
Country : US
Telephone Number : 646-762-4950
Fax Number : 646-762-4955
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2007
Last Update Date : 11/22/2021

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