Provider Demographics
NPI:1831642172
Name:OLUGU, NENA (NP)
Entity type:Individual
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First Name:NENA
Middle Name:
Last Name:OLUGU
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:101 NICOLLS RD
Mailing Address - Street 2:HSC LEVEL 12, RM 080, DEPARTMENT OF NEUROSURGERY
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-2566
Mailing Address - Country:US
Mailing Address - Phone:631-383-7828
Mailing Address - Fax:631-968-1022
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:HSC LEVEL 12, RM 080, DEPARTMENT OF NEUROSURGERY
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-2566
Practice Address - Country:US
Practice Address - Phone:631-383-7828
Practice Address - Fax:631-968-1022
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
NY30-307874363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner