Provider Demographics
NPI:1720651383
Name:ONWUMERE, GENEVIEVE BABYGOLD (NP)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:BABYGOLD
Last Name:ONWUMERE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 BUSINESS ST
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-2125
Mailing Address - Country:US
Mailing Address - Phone:617-834-6448
Mailing Address - Fax:
Practice Address - Street 1:150 S HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4817
Practice Address - Country:US
Practice Address - Phone:617-390-4720
Practice Address - Fax:857-364-3148
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2309187163W00000X
MARN2309187363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse