Provider Demographics
NPI:1669358651
Name:CHUKWUOCHA, CHIGOZIE ASRIEL
Entity type:Individual
Prefix:
First Name:CHIGOZIE
Middle Name:ASRIEL
Last Name:CHUKWUOCHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 NEPONSET AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02122-3103
Mailing Address - Country:US
Mailing Address - Phone:857-233-7778
Mailing Address - Fax:
Practice Address - Street 1:361 NEPONSET AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02122-3103
Practice Address - Country:US
Practice Address - Phone:857-233-7778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN100419164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse