Provider Demographics
NPI:1912020736
Name:ENEANYA, UCHE OGOCHUKWU (MD)
Entity Type:Individual
Prefix:DR
First Name:UCHE
Middle Name:OGOCHUKWU
Last Name:ENEANYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 SCOBEE DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-6508
Mailing Address - Country:US
Mailing Address - Phone:215-361-3562
Mailing Address - Fax:
Practice Address - Street 1:175 LANCASTER BLVD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-3562
Practice Address - Country:US
Practice Address - Phone:717-691-3755
Practice Address - Fax:717-691-3834
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT186303208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation