Provider Demographics
NPI:1043550783
Name:INDEPENDENT ENROLLMENT NURSING
Entity Type:Organization
Organization Name:INDEPENDENT ENROLLMENT NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDULHAKIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:716-578-1888
Mailing Address - Street 1:338 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-1422
Mailing Address - Country:US
Mailing Address - Phone:716-578-1888
Mailing Address - Fax:
Practice Address - Street 1:338 GRANT ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-1422
Practice Address - Country:US
Practice Address - Phone:716-578-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-16
Last Update Date:2013-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility