Provider Demographics
NPI:1275899064
Name:OJEVWE, CLEMENT O (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:CLEMENT
Middle Name:O
Last Name:OJEVWE
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8106
Mailing Address - Country:US
Mailing Address - Phone:718-655-5515
Mailing Address - Fax:718-408-3255
Practice Address - Street 1:2303 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-8106
Practice Address - Country:US
Practice Address - Phone:718-655-5515
Practice Address - Fax:718-408-3255
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY604685163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse