Provider Demographics
NPI:1255644241
Name:LEKWEUWA, LINDA AMARACHUKWU (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:AMARACHUKWU
Last Name:LEKWEUWA
Suffix:
Gender:
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 SEABURY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3651
Mailing Address - Country:US
Mailing Address - Phone:718-294-6200
Mailing Address - Fax:
Practice Address - Street 1:1371 SEABURY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3651
Practice Address - Country:US
Practice Address - Phone:718-515-3707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY628986-1163W00000X
NYF312058363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse