Individual provider Active NPI

Nancy Ezediaro-Efobi

  • General Practice Registered Nurse
  • Bronx, NY
National Provider Identifier
1306013859
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
548739 Issued in NY
Practice address
1780 Stillwell Avenue
Bronx, NY 10469-6409
Phone
(718) 652-9790
NPI assigned
May 14, 2008
Last updated
May 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 548739 NY Primary

Addresses

Primary practice location

1780 Stillwell Avenue
Bronx, NY 10469-6409

Mailing address

30 Albermarle Ave
New Rochelle, NY 10801-2001
Phone (914) 576-1415

Other names 1

  • Nancy Ezediaro-Efobi Professional name

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
548739NYMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy of New York City Inc Past Accepting new patients
United Cerebral Palsy of Nyc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1306013859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ALBERMARLE AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108012001",
            "telephone_number": "914-576-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 STILLWELL AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104696409",
            "telephone_number": "718-652-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEDIARO-EFOBI",
        "first_name": "NANCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "548739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "EZEDIARO-EFOBI",
            "credential": "REGISTERED NURSE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.