Provider Demographics
NPI:1689805913
Name:OJIMBA, CLIFFORD CHUKWUNONYE (LPN)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:CHUKWUNONYE
Last Name:OJIMBA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 HUNTS POINT AVE
Mailing Address - Street 2:APT 4B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10474-5970
Mailing Address - Country:US
Mailing Address - Phone:646-330-6673
Mailing Address - Fax:646-330-6673
Practice Address - Street 1:743 HUNTS POINT AVE
Practice Address - Street 2:APT 4B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10474-5970
Practice Address - Country:US
Practice Address - Phone:646-330-6673
Practice Address - Fax:646-330-6673
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297455164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse