Individual
OMONYEMEN IRENOSEN EBHOMIELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
560 W 168TH ST, NEW YORK, NY 10032-3917
(212) 305-4318
Mailing address
25630 CRAFT AVE, ROSEDALE, NY 11422-2700
(718) 341-3383
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
635881
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
635881
NY
Other
Enumeration date
07/28/2020
Last updated
10/24/2022
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