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NPI Code Detail

MEDICARE: GLORIA C IGBOKWE RN

MEDICARE: GLORIA C IGBOKWE RN
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
1163WH0200XHome Health Registered Nurse259485MA

General Provider Information

NPI Number : 1396962098
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLORIA C IGBOKWE RN
Provider Business Mailing Address
First Line : 361 NEPONSET AVE
Second Line :
City : DORCHESTER
State : MA
Zip : 02122-3103
Country : US
Telephone Number : 617-230-6844
Fax Number : 617-287-1256
Provider Business Practice Location Address
First Line : 361 NEPONSET AVE
Second Line :
City : DORCHESTER
State : MA
Zip : 02122-3103
Country : US
Telephone Number : 617-230-6844
Fax Number : 617-287-1256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2007
Last Update Date : 07/08/2007

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