Obianyor, Jackie

Obianyor, Jackie is an sole proprietor health care provider with primary practice located at 485 Front St #107, Hempstead NY 11550-4416. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Licensed Practical Nurse, Nursing Service Providers / Licensed Vocational Nurse. Nursing Service Providers / Licensed Practical Nurse is her primary health care specialty. Obianyor, Jackie can be contacted via phone (516) 214-4461.

Contact Information

Primary practice address
485 Front St #107 Hempstead NY 11550-4416
Phone: (516) 214-4461
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 246360-1 New York
Nursing Service Providers / Licensed Vocational Nurse 164X00000X 246360-1 New York

Profile Details

NPI number 1205011061
LBN Legal business name Obianyor, Jackie
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 28th, 2007
Last updated Dec 28th, 2007 - about 17 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 1205011061 NPPES
New York MEDICAID 02151577

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