Provider Demographics
NPI:1093076598
Name:OMEH, BETTER EZENWANYI (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BETTER
Middle Name:EZENWANYI
Last Name:OMEH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 VARIAN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-5935
Mailing Address - Country:US
Mailing Address - Phone:646-229-3080
Mailing Address - Fax:718-655-1879
Practice Address - Street 1:3660 VARIAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-5935
Practice Address - Country:US
Practice Address - Phone:646-229-3080
Practice Address - Fax:718-655-1879
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337166-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily