Provider Demographics
NPI:1043991870
Name:IROMUANYA, CHITURU N (MA)
Entity Type:Individual
Prefix:
First Name:CHITURU
Middle Name:N
Last Name:IROMUANYA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ORIENTAL BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4149
Mailing Address - Country:US
Mailing Address - Phone:718-344-0057
Mailing Address - Fax:
Practice Address - Street 1:301 ORIENTAL BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4149
Practice Address - Country:US
Practice Address - Phone:718-344-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ883514106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician