Provider Demographics
NPI:1891069357
Name:AGOHA, MAUREEN CHUKWUMUANYA (NP)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:CHUKWUMUANYA
Last Name:AGOHA
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Gender:F
Credentials:NP
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Mailing Address - Street 1:266 BRYANT AVE APT A
Mailing Address - Street 2:PADWE OFFICE
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2110
Mailing Address - Country:US
Mailing Address - Phone:845-499-5033
Mailing Address - Fax:914-948-8032
Practice Address - Street 1:266 BRYANT AVE APT A
Practice Address - Street 2:PADWE OFFICE
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2110
Practice Address - Country:US
Practice Address - Phone:845-499-5033
Practice Address - Fax:914-948-8032
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2013-10-18
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Provider Licenses
StateLicense IDTaxonomies
NY336234363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily