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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. POLYCARP I EZEOLU, PTA

Active Sole Proprietor

MR. POLYCARP I EZEOLU, PTA is a Home Health healthcare provider located in CORONA, New York. NPI 1558580795 is currently active in the NPPES registry. Verify at CMS.

Home Health · CORONA, NY

Registration Details

NPI Number
1558580795
Provider Type
Individual
Gender
Male
NPI Issued
Apr 25, 2007 (19.344325592804 yrs)
Last Updated
Jul 8, 2007
License
003536 (NY)
Sole Proprietor
Yes

Practice Information

Address
9832 57TH AVE
SUITE 12-G
CORONA, NY, 113684914
Browse NY providers · Browse ZIP 11368
Phone
7182710526
Primary Specialty
Home Health
251E00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.