Healthcare Provider Details

I. General information

NPI: 1265284525
Provider Name (Legal Business Name): NZUBECHUKWU JUDITH UGOCHUKWU M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 11/15/2024
Certification Date:
Deactivation Date: 11/04/2024
Reactivation Date: 11/15/2024

III. Provider practice location address

1901 FIRST AVENUE FLOOR 15
NEW YORK NY
10029
US

IV. Provider business mailing address

1901 FIRST AVENUE NYC H H/METROPOLITAN DEPARTMENT OF ME FLOOR 15
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-6771
  • Fax: 212-423-8099
Mailing address:
  • Phone: 212-423-6771
  • 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: