Provider Demographics
NPI:1306685813
Name:EMANAH, VICTOR STEVE (MBBS)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:STEVE
Last Name:EMANAH
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 E. 149TH STREET
Mailing Address - Street 2:SUITE 5-337
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451
Mailing Address - Country:US
Mailing Address - Phone:718-579-4739
Mailing Address - Fax:718-579-4836
Practice Address - Street 1:234 E. 149TH STREET
Practice Address - Street 2:SUITE 5-337
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-4739
Practice Address - Fax:718-579-4836
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2025-01-30
Deactivation Date:2025-01-14
Deactivation Code:
Reactivation Date:2025-01-30
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program