Provider Demographics
NPI:1508465980
Name:IWUJI, VICTORIA OGECHI
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:OGECHI
Last Name:IWUJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:OGECHI
Other - Last Name:IWUJI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE
Mailing Address - Street 1:9838 57TH AVE APT 5F
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-4923
Mailing Address - Country:US
Mailing Address - Phone:347-832-9602
Mailing Address - Fax:
Practice Address - Street 1:9838 57TH AVE APT 5F
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-4923
Practice Address - Country:US
Practice Address - Phone:347-832-9602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-18
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY778746-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY778746-01OtherNEW YORK STATE