Provider Demographics
NPI:1417631581
Name:CHUKWU, MICHAEL EZE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EZE
Last Name:CHUKWU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 EAST 68TH STREET, BOX # 312
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065
Mailing Address - Country:US
Mailing Address - Phone:926-237-0997
Mailing Address - Fax:
Practice Address - Street 1:525 EAST 68TH ST ROOM F734 #207
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065
Practice Address - Country:US
Practice Address - Phone:212-746-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2024-02-02
Deactivation Date:2024-01-12
Deactivation Code:
Reactivation Date:2024-02-02
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program