Provider Demographics
NPI:1619426327
Name:OGUERI, CHINEDU
Entity Type:Individual
Prefix:
First Name:CHINEDU
Middle Name:
Last Name:OGUERI
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 1:9220 216 TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENSVILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428
Mailing Address - Country:US
Mailing Address - Phone:646-361-8372
Mailing Address - Fax:
Practice Address - Street 1:9220 216 TH ST
Practice Address - Street 2:
Practice Address - City:QUEENSVILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428
Practice Address - Country:US
Practice Address - Phone:646-361-8372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312943164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse