Provider Demographics
NPI:1770456287
Name:IJEAKU, UCHENNA
Entity type:Individual
Prefix:
First Name:UCHENNA
Middle Name:
Last Name:IJEAKU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:961 WOOD PARK DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1235
Mailing Address - Country:US
Mailing Address - Phone:347-885-5627
Mailing Address - Fax:
Practice Address - Street 1:961 WOOD PARK DR
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1235
Practice Address - Country:US
Practice Address - Phone:347-885-5627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)