Provider Demographics
NPI:1073730776
Name:OHANENYE, NWANYIEZE CHRISTIANA (OD)
Entity Type:Individual
Prefix:DR
First Name:NWANYIEZE
Middle Name:CHRISTIANA
Last Name:OHANENYE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-3118
Mailing Address - Country:US
Mailing Address - Phone:215-874-4296
Mailing Address - Fax:215-874-4296
Practice Address - Street 1:2437 S 24TH ST
Practice Address - Street 2:SUITE E S PHILADELPHIA SHOPPING CTR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145
Practice Address - Country:US
Practice Address - Phone:215-468-3469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET009039152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist