Provider Demographics
NPI:1174005557
Name:ONYEKABA, STEPHANIE A (RN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:ONYEKABA
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 1:3137 SEYMOUR AVE # 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-3016
Mailing Address - Country:US
Mailing Address - Phone:917-600-0121
Mailing Address - Fax:
Practice Address - Street 1:3137 SEYMOUR AVE # 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-3016
Practice Address - Country:US
Practice Address - Phone:917-600-0121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY675827163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse