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Individual

MS. CATHERINE IJEDIMMA ONONUGBO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
159 HAWTHORNE AVE APT 264, CENTRAL ISLIP, NY 11722-1353
(631) 855-2164
Mailing address
159 HAWTHORNE AVE APT 264, CENTRAL ISLIP, NY 11722-1353
(631) 855-2164

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
765859
NY
164W00000X
Licensed Practical Nurse
2876761
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02902981
NY
Enumeration date
11/20/2007
Last updated
04/17/2020
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