Provider Demographics
NPI:1912950759
Name:ELEONU, NGOZI (DC)
Entity Type:Individual
Prefix:DR
First Name:NGOZI
Middle Name:
Last Name:ELEONU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5911 EDSALL ROAD
Mailing Address - Street 2:# PH-11
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304
Mailing Address - Country:US
Mailing Address - Phone:703-869-5258
Mailing Address - Fax:
Practice Address - Street 1:5911 EDSALL ROAD
Practice Address - Street 2:# PH-11
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304
Practice Address - Country:US
Practice Address - Phone:703-869-5258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA901642Medicare ID - Type UnspecifiedPART B, ARL./ALEX., VA
VAU68049Medicare UPIN
VA190001356Medicare ID - Type UnspecifiedPART B, STERLING, VA