Provider Demographics
NPI:1699525816
Name:IYAMU, BARBARA ADESUWA
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ADESUWA
Last Name:IYAMU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MEMORIAL HWY APT 23I
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-8337
Mailing Address - Country:US
Mailing Address - Phone:305-467-7729
Mailing Address - Fax:
Practice Address - Street 1:40 MEMORIAL HWY APT 23I
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-8337
Practice Address - Country:US
Practice Address - Phone:305-467-7729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY874161163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse