Provider Demographics
NPI:1013442938
Name:ONYENEGECHA, OSINACHI I
Entity Type:Individual
Prefix:
First Name:OSINACHI
Middle Name:
Last Name:ONYENEGECHA
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7715 RIVERDALE RD APT 304
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3943
Mailing Address - Country:US
Mailing Address - Phone:240-392-7213
Mailing Address - Fax:
Practice Address - Street 1:7715 RIVERDALE RD APT 304
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3943
Practice Address - Country:US
Practice Address - Phone:240-392-7213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC12728374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide