Provider Demographics
NPI:1467616425
Name:UDE-OSHIYOYE, NGOZI NNENNANYA (MD)
Entity Type:Individual
Prefix:MRS
First Name:NGOZI
Middle Name:NNENNANYA
Last Name:UDE-OSHIYOYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2 FRANKLIN TOWNE BLVD
Mailing Address - Street 2:1ST FLOOR WATERMARK BLDG
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1238
Mailing Address - Country:US
Mailing Address - Phone:215-253-5522
Mailing Address - Fax:
Practice Address - Street 1:2 FRANKLIN TOWNE BLVD
Practice Address - Street 2:1ST FLOOR WATERMARK BLDG
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-1238
Practice Address - Country:US
Practice Address - Phone:215-253-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD442668207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine