Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 306451 | NY |
NPI | 1003249228 |
---|---|
Provider Name | Chioma Onyemechi Chilaka |
First Address | Brooklyn, NY 11206-5317 |
Second Address | Brooklyn, NY 11206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2013 |
Last Update Date | 09/04/2015 |