Provider Demographics
NPI:1457976771
Name:ATANDA, UFUOMA
Entity Type:Individual
Prefix:
First Name:UFUOMA
Middle Name:
Last Name:ATANDA
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 1:2850 ROBERTS AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4814
Mailing Address - Country:US
Mailing Address - Phone:347-942-2700
Mailing Address - Fax:
Practice Address - Street 1:2850 ROBERTS AVE FL 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4814
Practice Address - Country:US
Practice Address - Phone:347-942-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies