Provider Demographics
NPI:1760618763
Name:NWAOHUOCHA, UGONMA CHRISTIANA (OD)
Entity Type:Individual
Prefix:DR
First Name:UGONMA
Middle Name:CHRISTIANA
Last Name:NWAOHUOCHA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2757 SEYMOUR AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5523
Mailing Address - Country:US
Mailing Address - Phone:718-427-6861
Mailing Address - Fax:
Practice Address - Street 1:671 SOUTHPARK BLVD
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-3617
Practice Address - Country:US
Practice Address - Phone:804-520-4390
Practice Address - Fax:804-520-4391
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007385152W00000X
VA0618002277152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1033470539Medicaid
NY03136032Medicaid
VA1033470539Medicaid