Provider Demographics
NPI:1184599508
Name:OGBENNAYA, EUNICE
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:OGBENNAYA
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 1:818 E 232ND ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-4410
Mailing Address - Country:US
Mailing Address - Phone:718-615-0049
Mailing Address - Fax:866-549-1599
Practice Address - Street 1:1412 BROADWAY STE 2128
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-9228
Practice Address - Country:US
Practice Address - Phone:718-615-0049
Practice Address - Fax:866-845-3415
Is Sole Proprietor?:No
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY796829163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse