Healthcare Provider Details

I. General information

NPI: 1669056065
Provider Name (Legal Business Name): UZOMA BENEDICT NJOKU MD, CHES, CDCA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11134 LUSCHEK DR
BLUE ASH OH
45241-2434
US

IV. Provider business mailing address

11134 LUSCHEK DR
BLUE ASH OH
45241-2434
US

V. Phone/Fax

Practice location:
  • Phone: 513-827-9273
  • Fax:
Mailing address:
  • Phone: 513-827-9273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.183914
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number34251
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: