Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | F001757 | NY |
NPI | 1033661400 |
---|---|
Provider Name | Morenike Jegede |
First Address | Middletown, NY 10940-2650 |
Second Address | Middletown, NY 10940-2650 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2016 |
Last Update Date | 10/08/2020 |