Provider Demographics
NPI:1700928124
Name:KALU, CHINENYE H (APRN)
Entity type:Individual
Prefix:
First Name:CHINENYE
Middle Name:H
Last Name:KALU
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE HOSPITAL PLAZA
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06904-9317
Mailing Address - Country:US
Mailing Address - Phone:203-276-7298
Mailing Address - Fax:203-276-4842
Practice Address - Street 1:ONE HOSPITAL PLAZA
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06904-9317
Practice Address - Country:US
Practice Address - Phone:203-276-7298
Practice Address - Fax:203-276-4842
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT074791163W00000X
CT003554363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT500001910Medicare PIN
CT004266294Medicaid