Provider Demographics
NPI:1295032027
Name:OJIELO, DOROTHY OBIAGELI
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:OBIAGELI
Last Name:OJIELO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 E GUN HILL RD
Mailing Address - Street 2:APT 6C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-3038
Mailing Address - Country:US
Mailing Address - Phone:347-602-6615
Mailing Address - Fax:
Practice Address - Street 1:1466 E GUN HILL RD
Practice Address - Street 2:APT 6C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-3038
Practice Address - Country:US
Practice Address - Phone:347-602-6615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258232-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse