Provider Demographics
NPI:1861650541
Name:OZIM, MERCY NKECHINYERE
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:NKECHINYERE
Last Name:OZIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 UNIVERSITY BLVD
Mailing Address - Street 2:APT.# 4C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-6911
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1632 UNIVERSITY BLVD
Practice Address - Street 2:APT.# 4C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-6911
Practice Address - Country:US
Practice Address - Phone:718-924-9525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282165-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse