Healthcare Provider Details

I. General information

NPI: 1104512037
Provider Name (Legal Business Name): CHUKWUEMEKA N UWAKANEME MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 W 168TH ST
NEW YORK NY
10032-3720
US

IV. Provider business mailing address

21 KUNA TER
IRVINGTON NJ
07111-3020
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-6262
  • Fax:
Mailing address:
  • Phone: 973-342-0775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: