Provider Demographics
NPI:1952946824
Name:NNAMDI-EZE, AMARACHI ANGELINA (PTA)
Entity Type:Individual
Prefix:
First Name:AMARACHI
Middle Name:ANGELINA
Last Name:NNAMDI-EZE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:AMARACHI
Other - Middle Name:ANGELINA
Other - Last Name:EJIOGU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5861 ROWANBERRY DR
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5241
Mailing Address - Country:US
Mailing Address - Phone:301-851-9804
Mailing Address - Fax:
Practice Address - Street 1:1150 VARNUM ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2180
Practice Address - Country:US
Practice Address - Phone:202-854-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant