Provider Demographics
NPI:1801414438
Name:EZE, ADAOBI EMEKA
Entity Type:Individual
Prefix:
First Name:ADAOBI
Middle Name:EMEKA
Last Name:EZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 MILES AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2607
Mailing Address - Country:US
Mailing Address - Phone:513-807-1982
Mailing Address - Fax:347-577-6045
Practice Address - Street 1:2610 MILES AVE APT 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2607
Practice Address - Country:US
Practice Address - Phone:513-807-1982
Practice Address - Fax:347-577-6045
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY663210163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty