Provider Demographics
NPI:1922712645
Name:OBI, MARIA NWAKANMAH (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:NWAKANMAH
Last Name:OBI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2224
Mailing Address - Country:US
Mailing Address - Phone:516-581-9416
Mailing Address - Fax:
Practice Address - Street 1:9 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2224
Practice Address - Country:US
Practice Address - Phone:516-581-9416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY541346163WS0200X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health