Basic Information
| Provider Information | |||||||||
| NPI: | 1447976501 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NNOROM | ||||||||
| FirstName: | AKUNNA | ||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11449 NEWBURGH ST | ||||||||
| Address2: | |||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114122628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3476060523 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22121 JAMAICA AVE | ||||||||
| Address2: | |||||||||
| City: | QUEENS VILLAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114282015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184686923 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2022 | ||||||||
| LastUpdateDate: | 10/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 345015 | NY | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.