Provider Demographics
NPI:1164801254
Name:IHEMEMBI, MARY VALENTINE (RN)
Entity Type:Individual
Prefix:
First Name:MARY VALENTINE
Middle Name:
Last Name:IHEMEMBI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W 44TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-5402
Mailing Address - Country:US
Mailing Address - Phone:212-586-6400
Mailing Address - Fax:212-397-7351
Practice Address - Street 1:305 W 44TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-5402
Practice Address - Country:US
Practice Address - Phone:212-586-6400
Practice Address - Fax:212-397-7351
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY628572163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse