Provider Demographics
NPI:1902171903
Name:IJEOMA, BLESSING (RN)
Entity Type:Individual
Prefix:MS
First Name:BLESSING
Middle Name:
Last Name:IJEOMA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 KINGS HWY
Mailing Address - Street 2:# 2H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2944
Mailing Address - Country:US
Mailing Address - Phone:716-200-2765
Mailing Address - Fax:
Practice Address - Street 1:528 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-1730
Practice Address - Country:US
Practice Address - Phone:718-827-8284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY597575163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse