Provider Demographics
NPI:1598560328
Name:ONYEULO, NOEL OGADIMMA
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:OGADIMMA
Last Name:ONYEULO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1944 E 75TH ST APT 304
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-4165
Mailing Address - Country:US
Mailing Address - Phone:216-612-7419
Mailing Address - Fax:
Practice Address - Street 1:1944 E 75TH ST APT 304
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4165
Practice Address - Country:US
Practice Address - Phone:216-612-7419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YA0400X, 172V00000X, 374U00000X
OH602927401124376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide