Awele Idemudia

Primary specialty

Infusion Therapy Registered NurseTaxonomy code 163WI0500X

License

564012 Issued in NY

Practice address

26 Dumont Ave
Staten Island, NY 10305-1450

Phone

(718) 667-4282

NPI assigned

Jul 29, 2022

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1770219826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S 13TH ST APT 2",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071074238",
            "telephone_number": "347-866-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 DUMONT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051450",
            "telephone_number": "718-667-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDEMUDIA",
        "first_name": "AWELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "NY",
            "license": "564012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "I18210716553512",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inna Ichtchenko, BS IN PHARMACY
• Ichthysroe, LLC
• Ics Care
• Idan Sharon, MD, PC
• Liza Idelchik, DDS
• Jincy Idicula, RPH
• Daniel Jose Idoate Domench
• Roseann Idone, M.S., CCC-SLP
• Idonia Luxe LLC
• Joel Akande Idowu, M.D.

• Infusion Therapy Registered Nurse in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Infusion Therapy Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.