Provider Demographics
NPI:1184986176
Name:ONYENWE, SARAH MUSU (NP)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MUSU
Last Name:ONYENWE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:MUSU
Other - Last Name:ONYENWE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, FNP-BC
Mailing Address - Street 1:260 ARDEN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1229
Mailing Address - Country:US
Mailing Address - Phone:718-979-2828
Mailing Address - Fax:
Practice Address - Street 1:260 ARDEN AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-1229
Practice Address - Country:US
Practice Address - Phone:718-966-5509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY598590163W00000X
NY337745363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04083029Medicaid