Provider Demographics
NPI:1346563624
Name:NALUYIMA, HERMENEGILDE MARY SR (NP-C)
Entity Type:Individual
Prefix:
First Name:HERMENEGILDE
Middle Name:MARY
Last Name:NALUYIMA
Suffix:SR
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 AQUINAS ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-3947
Mailing Address - Country:US
Mailing Address - Phone:920-517-7806
Mailing Address - Fax:
Practice Address - Street 1:4 AQUINAS ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-3947
Practice Address - Country:US
Practice Address - Phone:920-517-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305334-1364SA2200X
NY0305334363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF305334OtherNP CERTIFICATE NUMBER
NYF305334OtherNP CERTIFICATE NUMBER