Provider Demographics
NPI:1316213358
Name:ONWUMERE, CHIKEZIE C
Entity Type:Individual
Prefix:MR
First Name:CHIKEZIE
Middle Name:C
Last Name:ONWUMERE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15031 119TH RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2001
Mailing Address - Country:US
Mailing Address - Phone:347-217-1736
Mailing Address - Fax:
Practice Address - Street 1:1842 WESTERVELT AVE
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-2228
Practice Address - Country:US
Practice Address - Phone:347-217-1736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY#BN12001184332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies