Provider Demographics
NPI:1619239423
Name:NDUKA, ADAEZE (LMSW)
Entity Type:Individual
Prefix:
First Name:ADAEZE
Middle Name:
Last Name:NDUKA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-6008
Mailing Address - Country:US
Mailing Address - Phone:516-233-8629
Mailing Address - Fax:
Practice Address - Street 1:89-56 162ND ST. 2ND FLOOR
Practice Address - Street 2:CHILD CENTER OF NEW YORK- JAMAICA CLINIC
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5072
Practice Address - Country:US
Practice Address - Phone:718-657-7100
Practice Address - Fax:718-657-7137
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0824971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical