Provider Demographics
NPI:1952969594
Name:CHUKWUKERE, EJIKE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:EJIKE
Middle Name:
Last Name:CHUKWUKERE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 VAN CORTLANDT PARK S # 6CC11
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3003
Mailing Address - Country:US
Mailing Address - Phone:917-545-6200
Mailing Address - Fax:
Practice Address - Street 1:1580 ROUTE 112
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-3655
Practice Address - Country:US
Practice Address - Phone:631-207-9234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451907183500000X
NY067534183500000X
DEA1-0005123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist