Healthcare Provider Details

I. General information

NPI: 1306633797
Provider Name (Legal Business Name): UCHE UKENERU STEPHEN RT, BSC,B.AGRIC, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6323 GEORGIA AVE NW STE 300
WASHINGTON DC
20011-1141
US

IV. Provider business mailing address

6323 GEORGIA AVE NW STE 300
WASHINGTON DC
20011-1141
US

V. Phone/Fax

Practice location:
  • Phone: 202-905-1522
  • Fax:
Mailing address:
  • Phone: 202-905-1522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License Number1917
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2278E1000X
TaxonomyEducational Certified Respiratory Therapist
License Number1917
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number1917
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number1917
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code2278P1005X
TaxonomyPulmonary Rehabilitation Certified Respiratory Therapist
License Number1917
License Number StateDC
# 6
Primary TaxonomyN
Taxonomy Code2278P3800X
TaxonomyPalliative/Hospice Certified Respiratory Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2278S1500X
TaxonomySNF/Subacute Care Certified Respiratory Therapist
License Number1917
License Number StateDC
# 8
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number1917
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: