Provider Demographics
NPI:1942682992
Name:ALOGU, EVELYN C (ASN)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:C
Last Name:ALOGU
Suffix:
Gender:F
Credentials:ASN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ROCKWELL AVE
Mailing Address - Street 2:APT 3B
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1609
Mailing Address - Country:US
Mailing Address - Phone:347-820-4826
Mailing Address - Fax:
Practice Address - Street 1:10 ROCKWELL AVE
Practice Address - Street 2:APT 3B
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1609
Practice Address - Country:US
Practice Address - Phone:347-820-4826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-26
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY17865305OtherHIP PRIME