Egberongbe, Eniayo
Egberongbe, Eniayo is an sole proprietor health care provider with primary practice located at 1150 Reservoir Ave Ste 203 , Cranston RI 02920-6043. He recently has 4 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Egberongbe, Eniayo can be contacted via phone (401) 259-0340.Contact Information
Primary practice address
1150 Reservoir Ave Ste 203
Cranston RI 02920-6043
Phone: (401) 259-0340
Fax: (401) 259-0340
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | RN2330024 | Massachusetts |
| Nursing Service Providers / Psychiatric/Mental Health | 163WP0808X | 681574 | New York |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APRN01722 | Rhode Island |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | RN2330024 | Massachusetts |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | APRN01722 | Rhode Island |
Profile Details
| NPI number | 1295263515 |
|---|---|
| LBN Legal business name | Egberongbe, Eniayo |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 31st, 2017 |
| Last updated | Jun 29th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295263515 | NPPES |
| Rhode Island | MEDICAID | 363LP0808X |
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