Individual provider Active NPI

Ifeyinwa Mary Chukwu

  • Licensed Practical Nurse
  • Bronx, NY
National Provider Identifier
1326295114
Registry record updated Aug 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
293978-1 Issued in NY
Practice address
3536 Hull Ave
Apt 2C
Bronx, NY 10467-1617
Phone
(347) 275-7691
NPI assigned
Aug 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 293978-1 NY Primary

Addresses

Primary practice location

3536 Hull Ave
Apt 2C
Bronx, NY 10467-1617

Mailing address

3536 Hull Ave
Apt 2C
Bronx, NY 10467-1617
Phone (347) 275-7691

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
293978-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1326295114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 HULL AVE",
            "address_2": "APT 2C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104671617",
            "telephone_number": "347-275-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 HULL AVE",
            "address_2": "APT 2C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104671617",
            "telephone_number": "347-275-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUKWU",
        "first_name": "IFEYINWA",
        "middle_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "293978-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 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.