Chikaodili Ezedum
Individual provider Active NPI Registered Nurse · Stormville, NY
NPI 1508563024 · NPPES record last updated Feb 15, 2023
Key facts
- NPI
- 1508563024
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 541798 (NY)
- Practice address
- 594 Route 216
Stormville, NY 12582-5151 - Phone
- (845) 221-2711
- NPI assigned
- Feb 15, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 541798 | NY | Yes |
Addresses
Primary practice location
594 Route 216
Stormville, NY 12582-5151
Mailing address
3 Houghtailing LN
Wallkill, NY 12589-3973
Phone (845) 476-0733
Other providers in Stormville, NY
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- Sharon Dixon-Gordan
- Jennifer M Doherty
- Lori Ann Duke
- Dutchess Psychological Services PLLC
- Maryanne Regina Giordano
- Jacob Joji Jacob
- Russell Katz
- Dannielle Kealy
- Laura Teresa Keegan
All providers in Stormville, NY · Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.