Provider Demographics
NPI:1780209833
Name:EBERE, NKWACHI C (NP)
Entity Type:Individual
Prefix:
First Name:NKWACHI
Middle Name:C
Last Name:EBERE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:308 TORRY AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-1652
Mailing Address - Country:US
Mailing Address - Phone:917-693-8258
Mailing Address - Fax:212-939-1141
Practice Address - Street 1:506 LENOX AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1889
Practice Address - Country:US
Practice Address - Phone:212-939-4477
Practice Address - Fax:212-939-1141
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF402848363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health