Provider Demographics
NPI:1649566084
Name:CHINEME, CHRISTIANA IFEYINWA (REGISTERED PROFESSIO)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIANA
Middle Name:IFEYINWA
Last Name:CHINEME
Suffix:
Gender:F
Credentials:REGISTERED PROFESSIO
Other - Prefix:MRS
Other - First Name:CHRISTIANA
Other - Middle Name:IFEYINWA
Other - Last Name:UCHEGBU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED PROFESSIO
Mailing Address - Street 1:218-21 103RD AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429
Mailing Address - Country:US
Mailing Address - Phone:917-972-1490
Mailing Address - Fax:
Practice Address - Street 1:218-21 103RD AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429
Practice Address - Country:US
Practice Address - Phone:917-972-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY462172-1163W00000X, 163WC0400X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health