MEDICARE: NKENGE PATRICK

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	104100000X	Social Worker	074239	NY

General Provider Information

NPI Number	:	1952071714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NKENGE PATRICK

Provider Business Mailing Address
First Line	:	1061 CLAY AVE APT 3
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10456-5916
Country	:	US
Telephone Number	:	929-671-3864
Fax Number	:

Provider Business Practice Location Address
First Line	:	1061 CLAY AVE APT 3
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10456-5916
Country	:	US
Telephone Number	:	917-587-6394
Fax Number	:

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

Provider Enumeration Date	:	09/14/2021
Last Update Date	:	03/13/2026

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Directions to “ NKENGE PATRICK ” Practice Location

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