Provider Demographics
NPI:1821580101
Name:AGU, CHINYERE KELECHI (MD)
Entity Type:Individual
Prefix:DR
First Name:CHINYERE
Middle Name:KELECHI
Last Name:AGU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHINYERE
Other - Middle Name:KELECHI
Other - Last Name:ARUNGWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:32 GEORGETOWN LN
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5742
Mailing Address - Country:US
Mailing Address - Phone:347-978-6522
Mailing Address - Fax:
Practice Address - Street 1:32 GEORGETOWN LN
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5742
Practice Address - Country:US
Practice Address - Phone:347-978-6522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-03
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316474207RE0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program