Provider Demographics
NPI:1801040852
Name:ODAME-ADJEI, STELLA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:STELLA
Middle Name:
Last Name:ODAME-ADJEI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 HARRISON AVE
Mailing Address - Street 2:APT 3I
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-8400
Mailing Address - Country:US
Mailing Address - Phone:646-764-8731
Mailing Address - Fax:
Practice Address - Street 1:1730 HARRISON AVE
Practice Address - Street 2:APT 3I
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-8400
Practice Address - Country:US
Practice Address - Phone:646-764-8731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273855-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse