Provider Demographics
NPI:1376972760
Name:UKWU, CYNTHIA CHIOMA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:CHIOMA
Last Name:UKWU
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 BEACH 19TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4430
Mailing Address - Country:US
Mailing Address - Phone:646-404-2794
Mailing Address - Fax:
Practice Address - Street 1:2108 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2103
Practice Address - Country:US
Practice Address - Phone:212-987-1372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist