1194874172 NPI number — DR. CYNTHIA I NWOKEUKU AUSTIN MD

Table of content: DR. CYNTHIA I NWOKEUKU AUSTIN MD (NPI 1194874172)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194874172 NPI number — DR. CYNTHIA I NWOKEUKU AUSTIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NWOKEUKU AUSTIN
Provider First Name:
CYNTHIA
Provider Middle Name:
I
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NWOKEUKU AUSTIN
Provider Other First Name:
CYNTHIA
Provider Other Middle Name:
I
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1194874172
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7009
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRFAX STATION
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22039-7009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
571-492-7636
Provider Business Mailing Address Fax Number:
540-683-8494

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4333 OLD BRANCH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEMPLE HILLS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20748-1848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-423-4551
Provider Business Practice Location Address Fax Number:
540-683-8494
Provider Enumeration Date:
01/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  0101054967 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com