Healthcare Provider Details

I. General information

NPI: 1013111707
Provider Name (Legal Business Name): UZOMA N UKOMADU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 DEKALB AVE ORTHOSUITE
BROOKLYN NY
11201-5425
US

IV. Provider business mailing address

820 BARTHOLDI ST
BRONX NY
10467-6214
US

V. Phone/Fax

Practice location:
  • Phone: 718-250-7700
  • Fax:
Mailing address:
  • Phone: 646-303-4247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number266266
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: