Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 190077 | NY |
NPI | 1063692168 |
---|---|
Provider Name | Dominic Emeka Onyema |
First Address | New York, NY 10016-4914 |
Second Address | New York, NY 10017-2417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2007 |
Last Update Date | 10/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01624244 | (05) | NY |
085AS2 | EMPIRE BLUE CROSS/BLUE SH (01) | NY |
F70005 | (02) | NY |