Individual
MR. NNACHI O MBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1276 FULTON AVE, BRONX, NY 10456-3402
(718) 901-8825
Mailing address
1700 HARRISON AVE APT 1D, BRONX, NY 10453-7090
(347) 307-4644
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402602
NY
Other
Enumeration date
06/02/2019
Last updated
06/02/2019
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