Individual
OKWUCHUKWU INNOCENT UDEMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
1150 WEBSTER AVE STE 3, BRONX, NY 10456-5205
(347) 271-7666
Mailing address
1150 WEBSTER AVE STE 3, BRONX, NY 10456-5205
(347) 271-7666
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
766300
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F405802-01
NY
Other
Enumeration date
04/02/2019
Last updated
09/24/2025
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