Provider Demographics
NPI:1376368001
Name:EZE, PAULINUS CHINYERE
Entity type:Individual
Prefix:
First Name:PAULINUS
Middle Name:CHINYERE
Last Name:EZE
Suffix:
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 1:3019 MARTIN LUTHER KING JR AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3117
Mailing Address - Country:US
Mailing Address - Phone:202-800-4433
Mailing Address - Fax:
Practice Address - Street 1:3019 MARTIN LUTHER KING JR
Practice Address - Street 2:AVE SE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2001
Practice Address - Country:US
Practice Address - Phone:202-800-4433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator