Doctor Name: | ABIEYUWA EBOIKPOMWEN |
NPI Number: | 1043404635 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 404 W Fountain St Albert Lea, MN - 560072437 |
Business Phone Number: | 7864881749 |
Business Fax Number: | |
Mailing Address: | 300 Lenox Rd, Apt 7k BROOKLYN |
State: | NY |
Postal Code: | 112262273 |
Phone Number: | 7864881749 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2007 |
NPI Last Update Date: | 04/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 08/31/2009 |
NPI Reactivation Date: | 08/24/2012 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |