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General NPI Number Information
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NPI Number | 1881066058
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Entity Type | Organization
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Legal Business Name | DR N
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 1950 ANDERSON HWY
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City | POWHATAN
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State | VA
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Zip | 23139-7918
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Country | US
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Telephone | 804-379-0555
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Fax | 804-379-0255
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Provider Business Mailing Address
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Address Line | 613 COLONIAL AVE
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-3421
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. UGONMA C NWAOHUOCHA
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Credential | O.D
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Telephone | 718-427-6861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618002277
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License Number State | VA
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