Izehi Agenmonmen Eromosele, NP
Nurse Practitioner, Family in Brooklyn, NY. Individual provider (NPI-1).
NPI number1003124660
StatusActive
Last updated in NPPESSep 17, 2025
Details
- NPI
- 1003124660
- Entity type
- Individual (NPI-1)
- Name
- Ms. Izehi Agenmonmen Eromosele
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 16, 2010
- Certification date
- Sep 17, 2025
- Last updated
- Sep 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 341154 | NY | Yes |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 405807 | NY | |
| 363LF0000X | Nurse Practitioner, Family | 341154-01 | NY | |
| 163W00000X | Registered Nurse | 580957 | NY |
Practice location
539 Vandalia AveBrooklyn, NY 11239-2810
Phone 718-642-3213
Mailing address
539 Vandalia AveBrooklyn, NY 11239-2853
Phone 646-287-0094 · Fax 800-707-8708
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