Provider Demographics
NPI:1194514471
Name:EZE, IFEYINWA
Entity type:Individual
Prefix:
First Name:IFEYINWA
Middle Name:
Last Name:EZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 PARK AVE S # 458883
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-1502
Mailing Address - Country:US
Mailing Address - Phone:800-539-4180
Mailing Address - Fax:
Practice Address - Street 1:201 E 125TH ST STE 112
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1739
Practice Address - Country:US
Practice Address - Phone:929-508-6672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier