Provider Demographics
NPI:1609380294
Name:IYEKE, ANDREAS
Entity type:Individual
Prefix:
First Name:ANDREAS
Middle Name:
Last Name:IYEKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SHEARWOOD PL APT 918
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6615
Mailing Address - Country:US
Mailing Address - Phone:347-207-2972
Mailing Address - Fax:
Practice Address - Street 1:1 SHEARWOOD PL APT 918
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6615
Practice Address - Country:US
Practice Address - Phone:347-207-2972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-19
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY700811163WS0200X
NYF345919363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool