Provider Demographics
NPI:1982373072
Name:NDUKA, NGOZI-CHUKWU
Entity Type:Individual
Prefix:
First Name:NGOZI-CHUKWU
Middle Name:
Last Name:NDUKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 MONTGOMERY AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1553
Mailing Address - Country:US
Mailing Address - Phone:610-660-8200
Mailing Address - Fax:
Practice Address - Street 1:915 MONTGOMERY AVE STE 310
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19072-1553
Practice Address - Country:US
Practice Address - Phone:610-660-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL015473235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist