Provider Demographics
NPI:1265299671
Name:NRIAGU, UGONWA NKECHI (RPH)
Entity type:Individual
Prefix:
First Name:UGONWA
Middle Name:NKECHI
Last Name:NRIAGU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 WALLACE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2840
Mailing Address - Country:US
Mailing Address - Phone:267-408-4323
Mailing Address - Fax:
Practice Address - Street 1:5701 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-3235
Practice Address - Country:US
Practice Address - Phone:267-307-3609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist