Provider Demographics
NPI:1821630369
Name:FODAY-KAKPA, HALIMATTU MARIAM (FNP)
Entity Type:Individual
Prefix:
First Name:HALIMATTU
Middle Name:MARIAM
Last Name:FODAY-KAKPA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 SEABURY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3629
Mailing Address - Country:US
Mailing Address - Phone:718-294-6200
Mailing Address - Fax:718-294-6859
Practice Address - Street 1:1371 SEABURY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-294-6200
Practice Address - Fax:718-294-6859
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF343609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily