Gertrude L Ihenacho, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

012280-1 Issued in NY

Practice address

36 Sevent H Avenue, O'Toote. 1St Floor, RM 1088
New York, NY 10011

Phone

(212) 356-4573

Fax

(646) 473-1004

NPI assigned

Jun 2, 2010

Last updated

Jun 2, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1437479375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W 124TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100275634",
            "telephone_number": "212-289-5655",
            "fax_number": "212-987-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 SEVENT H AVENUE, O'TOOTE. 1ST FLOOR, RM 1088",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011",
            "telephone_number": "212-356-4573",
            "fax_number": "646-473-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHENACHO",
        "first_name": "GERTRUDE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012280-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.