Provider Demographics
NPI:1346510765
Name:EGBUNA, UCHENNA
Entity Type:Individual
Prefix:
First Name:UCHENNA
Middle Name:
Last Name:EGBUNA
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 1:29 LORAINE ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-1822
Mailing Address - Country:US
Mailing Address - Phone:631-397-0159
Mailing Address - Fax:
Practice Address - Street 1:29 LORAINE ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-1822
Practice Address - Country:US
Practice Address - Phone:631-397-0159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information