MEDICARE: IFEYINWA EZE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1194514471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IFEYINWA EZE

Provider Business Mailing Address
First Line	:	228 PARK AVE S # 458883
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-1502
Country	:	US
Telephone Number	:	800-539-4180
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 E 125TH ST STE 112
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-1739
Country	:	US
Telephone Number	:	929-508-6672
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2025
Last Update Date	:	05/03/2025

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Directions to “ IFEYINWA EZE ” Practice Location

Language	Start Address	Practice Location

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