Provider Demographics
NPI:1457653800
Name:NFONOYIM, QUINTA NDIP (RN, LPN)
Entity Type:Individual
Prefix:MS
First Name:QUINTA
Middle Name:NDIP
Last Name:NFONOYIM
Suffix:
Gender:F
Credentials:RN, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 NETHERLAND AVE APT B
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-2508
Mailing Address - Country:US
Mailing Address - Phone:718-902-4080
Mailing Address - Fax:
Practice Address - Street 1:192 NETHERLAND AVE APT B
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-2508
Practice Address - Country:US
Practice Address - Phone:718-902-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY805705163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse