Provider Demographics
NPI:1346572021
Name:MWANGANGYE, HARRIET (RN)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:
Last Name:MWANGANGYE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 JOANNE DR
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-6346
Mailing Address - Country:US
Mailing Address - Phone:607-262-0697
Mailing Address - Fax:
Practice Address - Street 1:138 CECIL MALONE DR
Practice Address - Street 2:COMMUNITY HEALTH AND HOME CARE
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:607-273-7780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY574259-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse