Provider Demographics
NPI:1518570175
Name:ONYENAOBIYA, CHIDIEBERE STELLA
Entity Type:Individual
Prefix:
First Name:CHIDIEBERE
Middle Name:STELLA
Last Name:ONYENAOBIYA
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 1:120 ERDMAN PL APT 20B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-5332
Mailing Address - Country:US
Mailing Address - Phone:917-348-7723
Mailing Address - Fax:
Practice Address - Street 1:120 ERDMAN PL APT 20B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-5332
Practice Address - Country:US
Practice Address - Phone:917-348-7723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency