Healthcare Provider Details

I. General information

NPI: 1952589335
Provider Name (Legal Business Name): CHUKS J. ONWU SURGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 02/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3771 NESCONSET HWY SUITE 103
SOUTH SETAUKET NY
11720-1163
US

IV. Provider business mailing address

PO BOX 3396
PATCHOGUE NY
11772-0019
US

V. Phone/Fax

Practice location:
  • Phone: 631-689-5384
  • Fax: 631-689-5396
Mailing address:
  • Phone: 631-689-5384
  • Fax: 631-689-5396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHUKS J ONWU
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 631-689-5384