MEDICARE: CHIOMA CHIMA

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	582584	NY

General Provider Information

NPI Number	:	1568692622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIOMA CHIMA

Provider Business Mailing Address
First Line	:	1320 HICKS ST APT 2C
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-1726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 HICKS ST
Second Line	:	APT 2C
City	:	BRONX
State	:	NY
Zip	:	10469-1730
Country	:	US
Telephone Number	:	917-402-8695
Fax Number	:

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

Provider Enumeration Date	:	07/22/2009
Last Update Date	:	07/22/2009

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Directions to “ CHIOMA CHIMA ” Practice Location

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