Provider Demographics
NPI:1174867337
Name:UGWEJEH, KELVIN AMAECHI (BSN RN)
Entity type:Individual
Prefix:MR
First Name:KELVIN
Middle Name:AMAECHI
Last Name:UGWEJEH
Suffix:
Gender:M
Credentials:BSN RN
Other - Prefix:
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Mailing Address - Street 1:638 UNDERHILL AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2926
Mailing Address - Country:US
Mailing Address - Phone:929-473-4474
Mailing Address - Fax:718-654-2595
Practice Address - Street 1:638 UNDERHILL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2926
Practice Address - Country:US
Practice Address - Phone:929-473-4474
Practice Address - Fax:718-654-2595
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2020-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY312407-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse