Provider Demographics
NPI:1396195434
Name:EKEKE, CHIKAMUNARIO JOY
Entity Type:Individual
Prefix:MS
First Name:CHIKAMUNARIO
Middle Name:JOY
Last Name:EKEKE
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 1:22610 146TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3815
Mailing Address - Country:US
Mailing Address - Phone:516-710-4439
Mailing Address - Fax:718-413-7541
Practice Address - Street 1:22610 146TH AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-3815
Practice Address - Country:US
Practice Address - Phone:516-710-4439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY562677163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse