Provider Demographics
NPI:1013738582
Name:ACHONU, CHUKWUEMEKA JOHNSON (OD)
Entity type:Individual
Prefix:
First Name:CHUKWUEMEKA
Middle Name:JOHNSON
Last Name:ACHONU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3356 BEECHCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-5101
Mailing Address - Country:US
Mailing Address - Phone:978-856-9108
Mailing Address - Fax:
Practice Address - Street 1:260 TREMONT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5603
Practice Address - Country:US
Practice Address - Phone:617-636-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOPT5742152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist