Provider Demographics
NPI:1023575081
Name:OFURUM-ONONIWU, CHINYERE MMAKU (FNP)
Entity Type:Individual
Prefix:
First Name:CHINYERE
Middle Name:MMAKU
Last Name:OFURUM-ONONIWU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-1211
Mailing Address - Country:US
Mailing Address - Phone:617-291-7124
Mailing Address - Fax:
Practice Address - Street 1:351 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:MA
Practice Address - Zip Code:02370-1211
Practice Address - Country:US
Practice Address - Phone:617-291-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2018086507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine