Provider Demographics
NPI:1104187954
Name:FUH, IRENE MANKASIBE
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:MANKASIBE
Last Name:FUH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 ANN DR APT 304
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-2606
Mailing Address - Country:US
Mailing Address - Phone:240-476-5680
Mailing Address - Fax:
Practice Address - Street 1:210 ANN DR APT 304
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-2606
Practice Address - Country:US
Practice Address - Phone:240-476-5680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0000201163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health