Provider Demographics
NPI:1023324761
Name:OFUYAH, ELIZABETH OGHENERUEMU (RN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:OGHENERUEMU
Last Name:OFUYAH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 IROQUOIS AVE
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-3821
Mailing Address - Country:US
Mailing Address - Phone:631-880-7311
Mailing Address - Fax:
Practice Address - Street 1:577 E 139TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-2305
Practice Address - Country:US
Practice Address - Phone:718-292-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY436453163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse