Provider Demographics
NPI: | 1306633797 |
---|---|
Name: | UKENERU STEPHEN, UCHE (RT, BSC,BAGRIC, MBA) |
Entity type: | Individual |
Prefix: | |
First Name: | UCHE |
Middle Name: | |
Last Name: | UKENERU STEPHEN |
Suffix: | |
Gender: | M |
Credentials: | RT, BSC,BAGRIC, MBA |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 6323 GEORGIA AVE NW STE 300 |
Mailing Address - Street 2: | |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20011-1141 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 202-905-1522 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6323 GEORGIA AVE NW STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | WASHINGTON |
Practice Address - State: | DC |
Practice Address - Zip Code: | 20011-1141 |
Practice Address - Country: | US |
Practice Address - Phone: | 202-905-1522 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2025-04-21 |
Last Update Date: | 2025-04-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
DC | 1917 | 2278C0205X, 2278E1000X, 2278G1100X, 2278H0200X, 2278P1005X, 2278S1500X, 227800000X |
2278P3800X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 227800000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | ||
No | 2278C0205X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Critical Care | |
No | 2278E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Educational | |
No | 2278G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | General Care | |
No | 2278H0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Home Health | |
No | 2278P1005X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Pulmonary Rehabilitation | |
No | 2278P3800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Palliative/Hospice | |
No | 2278S1500X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | SNF/Subacute Care | Group - Multi-Specialty |