Provider Demographics
NPI:1629647342
Name:ASOGWA, NNEDINDU (MD)
Entity Type:Individual
Prefix:
First Name:NNEDINDU
Middle Name:
Last Name:ASOGWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NNEDI
Other - Middle Name:MARIA
Other - Last Name:ASADU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:475 SEAVIEW AVENUE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:475 SEAVIEW AVENUE
Practice Address - Street 2:
Practice Address - City:STATENISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-226-8313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2023-01-30
Deactivation Date:2022-12-05
Deactivation Code:
Reactivation Date:2023-01-30
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program