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General NPI Number Information
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NPI Number | 1386368512
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Entity Type | Individual
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Provider Name | RAPHAEL EBUBECHUKWU ONYEKACHI
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Gender | Male
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Dates
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Enumeration Date | 09/30/2022
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Last Update Date | 09/30/2022
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Provider Practice Location Address
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Address Line | 4113 EUBANK BLVD NE STE 200E
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3482
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Country | US
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Telephone | 505-910-8496
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Fax |
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Provider Business Mailing Address
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Address Line | 700 EUBANK BLVD SE APT 518
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-1300
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Country | US
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Telephone | 470-461-7149
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | NM
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