Provider Demographics
NPI:1013340769
Name:UKA, GLORY CHIGOZIRI (MSC ED)
Entity Type:Individual
Prefix:MRS
First Name:GLORY
Middle Name:CHIGOZIRI
Last Name:UKA
Suffix:
Gender:F
Credentials:MSC ED
Other - Prefix:MISS
Other - First Name:NNENNA
Other - Middle Name:
Other - Last Name:OBUBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2031 HUGHES AVE APT 4A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-4852
Mailing Address - Country:US
Mailing Address - Phone:646-399-4914
Mailing Address - Fax:
Practice Address - Street 1:2031 HUGHES AVE APT 4A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4852
Practice Address - Country:US
Practice Address - Phone:646-399-4914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7625055132174400000X
NY762504132174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist