Provider Demographics
NPI:1558981852
Name:NGOWI, AMOURICE ELISIFA
Entity Type:Individual
Prefix:
First Name:AMOURICE
Middle Name:ELISIFA
Last Name:NGOWI
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 1:17 DEER RUN DR APT D
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839-1082
Mailing Address - Country:US
Mailing Address - Phone:518-231-2853
Mailing Address - Fax:
Practice Address - Street 1:17 DEER RUN DR APT D
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-1082
Practice Address - Country:US
Practice Address - Phone:518-231-2853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)