Provider Demographics
NPI:1407450133
Name:NNAJIOFOR, IFEYINWA (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:IFEYINWA
Middle Name:
Last Name:NNAJIOFOR
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10575 FLATLANDS 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3009
Mailing Address - Country:US
Mailing Address - Phone:347-777-8894
Mailing Address - Fax:
Practice Address - Street 1:3636 33RD ST STE 306
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-2329
Practice Address - Country:US
Practice Address - Phone:844-403-4325
Practice Address - Fax:424-625-0010
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY431911363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care