Provider Demographics
NPI:1235390980
Name:NWOGU, NGOZI (FNP)
Entity Type:Individual
Prefix:
First Name:NGOZI
Middle Name:
Last Name:NWOGU
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 1:496 CLAREMONT PKWY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-8306
Mailing Address - Country:US
Mailing Address - Phone:646-505-8441
Mailing Address - Fax:
Practice Address - Street 1:496 CLAREMONT PKWY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8306
Practice Address - Country:US
Practice Address - Phone:646-505-8441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY522913-1163W00000X
NYF337123-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse