Healthcare Provider Details

I. General information

NPI: 1851211288
Provider Name (Legal Business Name): ANTHONY IKECHUKWU EZE AGNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 DECATUR ST NE
WASHINGTON DC
20017-3917
US

IV. Provider business mailing address

800 DECATUR ST NE
WASHINGTON DC
20017-3917
US

V. Phone/Fax

Practice location:
  • Phone: 202-718-1764
  • Fax:
Mailing address:
  • Phone: 202-718-1764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberNP1036790
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: