Ibe, Shade Onyema Mckissick

Ibe, Shade Onyema Mckissick is an individual health care provider with primary practice located at 546 Eastern Pkwy , Brooklyn NY 11225-1604. She recently has only one registered license in Other Service Providers / Health Educator, which is considered as her primary health care specialty. Ibe, Shade Onyema Mckissick can be contacted via phone (855) 283-2156.

Contact Information

Primary practice address
546 Eastern Pkwy Brooklyn NY 11225-1604
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Health Educator 174H00000X

Profile Details

NPI number 1295363968
LBN Legal business name Ibe, Shade Onyema Mckissick
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2020
Last updated Mar 30th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295363968 NPPES
New York MEDICAID 1811520810

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