Individual provider Active NPI

Eunice O Bamgbade

  • Registered Nurse
  • Clifton, NJ
National Provider Identifier
1053842260
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
26NR11500400 Issued in NJ
Practice address
404 Clifton Ave
Clifton, NJ 07011-2614
Phone
(856) 426-9520
NPI assigned
Mar 21, 2017
Last updated
Mar 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR11500400 NJ Primary

Addresses

Primary practice location

404 Clifton Ave
Clifton, NJ 07011-2614

Mailing address

404 Clifton Ave
Clifton, NJ 07011-2614
Phone (856) 426-9520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26NR11500400NJMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Zion Home Health Care Services Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1053842260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112614",
            "telephone_number": "856-426-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112614",
            "telephone_number": "856-426-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMGBADE",
        "first_name": "EUNICE",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR11500400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.