Individual
CHINEDU MANASSEH DIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21 LAUREL DR, BRENTWOOD, NY 11717-2322
(718) 813-2526
Mailing address
21 LAUREL DR, BRENTWOOD, NY 11717-2322
(718) 813-2526
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
299569
NY
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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