Provider Demographics
NPI:1801274907
Name:IZU, DAAMI IDUOKU (RN)
Entity type:Individual
Prefix:
First Name:DAAMI
Middle Name:IDUOKU
Last Name:IZU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 PARKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-3820
Mailing Address - Country:US
Mailing Address - Phone:316-768-9918
Mailing Address - Fax:
Practice Address - Street 1:508 AIRPORT EXECUTIVE BOULEVARD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10958
Practice Address - Country:US
Practice Address - Phone:845-425-2655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY676525-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse