Provider Demographics
NPI:1669739058
Name:CHIMA, ANTHONY NDUKWE (REGISTERED NURSE, C)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:NDUKWE
Last Name:CHIMA
Suffix:
Gender:M
Credentials:REGISTERED NURSE, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 TRATMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3460
Mailing Address - Country:US
Mailing Address - Phone:718-409-9040
Mailing Address - Fax:718-931-8121
Practice Address - Street 1:2555 TRATMAN AVE.
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-409-9040
Practice Address - Fax:718-931-8121
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY458796163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health