Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bassey Ulo Enyenihi

Individual provider Family Nurse Practitioner · NPI 1093311409

Bassey Ulo Enyenihi is a Nurse Practitioner in Manorville, New York. Qualified in 2018, 8 years ago. Practices as a sole proprietor. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2020

Practice location Address checks out

287 Wading River Rd Ste 8
Manorville, NY 11949-1194
Phone: (631) 716-5410
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F343092-1 (NY)

Record details

NPI number1093311409
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 10, 2020
Last updated in NPPESDecember 10, 2020
Certification dateDecember 9, 2020
Mailing address17 Birchgrove Dr, Central Islip, NY 11722-1904

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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