Individual
CONSOLE IFEZULUMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 ALBANY ST, ELMONT, NY 11003-5010
(917) 940-8220
Mailing address
27 ALBANY ST, ELMONT, NY 11003-5010
(917) 940-8220
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
827621
NY
164W00000X
Licensed Practical Nurse
337045
NY
Other
Enumeration date
07/06/2020
Last updated
10/05/2021
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