Provider Demographics
NPI:1225306509
Name:GBADUO, IGNATIUS A (RN, MSN, FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:IGNATIUS
Middle Name:A
Last Name:GBADUO
Suffix:
Gender:M
Credentials:RN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W 30TH ST
Mailing Address - Street 2:6 B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2710
Mailing Address - Country:US
Mailing Address - Phone:518-577-7814
Mailing Address - Fax:646-638-1842
Practice Address - Street 1:314 W 14TH ST
Practice Address - Street 2:FL 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-5002
Practice Address - Country:US
Practice Address - Phone:646-638-2015
Practice Address - Fax:646-638-1842
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily