Provider Demographics
NPI:1952858656
Name:CONDUA, NANA
Entity Type:Individual
Prefix:
First Name:NANA
Middle Name:
Last Name:CONDUA
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 1:120 CASALS PL
Mailing Address - Street 2:10J
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-3102
Mailing Address - Country:US
Mailing Address - Phone:347-324-1973
Mailing Address - Fax:
Practice Address - Street 1:120 CASALS PL
Practice Address - Street 2:10J
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-3102
Practice Address - Country:US
Practice Address - Phone:347-324-1973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY635950-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health