Provider Demographics
NPI:1063692168
Name:ONYEMA, DOMINIC EMEKA (MD)
Entity type:Individual
Prefix:
First Name:DOMINIC
Middle Name:EMEKA
Last Name:ONYEMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E 34TH ST
Mailing Address - Street 2:SUITE SOUTH 34C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4914
Mailing Address - Country:US
Mailing Address - Phone:212-686-5782
Mailing Address - Fax:212-532-6881
Practice Address - Street 1:20 E 46TH ST
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-2417
Practice Address - Country:US
Practice Address - Phone:646-490-5475
Practice Address - Fax:646-559-4673
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2014-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY190077207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY085AS2OtherEMPIRE BLUE CROSS/BLUE SH
NY01624244Medicaid
NY085AS2OtherEMPIRE BLUE CROSS/BLUE SH
NY10H532Medicare PIN