Provider Demographics
NPI:1992956288
Name:KADENHE-CHIWESHE, ANGELA VIMBAYI (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:VIMBAYI
Last Name:KADENHE-CHIWESHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:VIMBAYI
Other - Last Name:KADENHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9 ROCKY RAPIDS RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06903-3131
Mailing Address - Country:US
Mailing Address - Phone:646-483-0965
Mailing Address - Fax:
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:646-962-2599
Practice Address - Fax:212-746-3884
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-04
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2478132086S0120X
VA01012800792086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03106021Medicaid