Provider Demographics
NPI:1992441679
Name:NICHE HAND SURGERY AND ORTHOPEDICS PLLC
Entity type:Organization
Organization Name:NICHE HAND SURGERY AND ORTHOPEDICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UGOCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOROAFOR-RIDGWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-894-0695
Mailing Address - Street 1:9480 MAIN ST # 1129
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4032
Mailing Address - Country:US
Mailing Address - Phone:703-894-0695
Mailing Address - Fax:800-770-6204
Practice Address - Street 1:8500 EXECUTIVE PARK AVE STE 310
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2249
Practice Address - Country:US
Practice Address - Phone:703-894-0695
Practice Address - Fax:703-783-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty