Provider Demographics
NPI:1659838639
Name:EKEKWE, SEAN ONYIYECHI (DPT)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:ONYIYECHI
Last Name:EKEKWE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 REGENCY PL STE 100
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3085
Mailing Address - Country:US
Mailing Address - Phone:301-934-5336
Mailing Address - Fax:301-934-0498
Practice Address - Street 1:4470 REGENCY PL STE 100
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3085
Practice Address - Country:US
Practice Address - Phone:301-934-5336
Practice Address - Fax:301-934-0498
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27344225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist