Provider Demographics
NPI:1821380882
Name:NSIAH, MAGDALINE ROBERTA EKYA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:MAGDALINE
Middle Name:ROBERTA EKYA
Last Name:NSIAH
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 1:567 SOUTHERN BLVD
Mailing Address - Street 2:APT. 4B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-3703
Mailing Address - Country:US
Mailing Address - Phone:646-270-7922
Mailing Address - Fax:
Practice Address - Street 1:567 SOUTHERN BLVD
Practice Address - Street 2:APT. 4B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-3703
Practice Address - Country:US
Practice Address - Phone:646-270-7922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299969-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse