Provider Demographics
NPI:1871385120
Name:NWAEZE, HENRY CHINONSO (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:CHINONSO
Last Name:NWAEZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HENRY
Other - Middle Name:CHINONSO
Other - Last Name:NWAEZE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:545 CENTRAL AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:LA
Mailing Address - Zip Code:70121-1402
Mailing Address - Country:US
Mailing Address - Phone:832-202-3715
Mailing Address - Fax:
Practice Address - Street 1:2612 METAIRIE RD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5426
Practice Address - Country:US
Practice Address - Phone:888-880-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician