Provider Demographics
NPI:1952854689
Name:OBI, CHINWEUCHE (OWNER)
Entity Type:Individual
Prefix:MR
First Name:CHINWEUCHE
Middle Name:
Last Name:OBI
Suffix:
Gender:M
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CLIFTON TERRACE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632
Mailing Address - Country:US
Mailing Address - Phone:201-888-8904
Mailing Address - Fax:201-431-9260
Practice Address - Street 1:10 HILLSIDE AVE #8
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3042
Practice Address - Country:US
Practice Address - Phone:201-888-8904
Practice Address - Fax:201-431-9260
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver