Polycarp I Ezeolu, PTA

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

003536 Issued in NY

Practice address

9832 57TH Ave
Suite 12-G
Corona, NY 11368-4914

Phone

(718) 271-0526

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558580795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9832 57TH AVE",
            "address_2": "SUITE 12-G",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113684914",
            "telephone_number": "718-271-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9832 57TH AVE",
            "address_2": "SUITE 12-G",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113684914",
            "telephone_number": "718-271-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEOLU",
        "first_name": "POLYCARP",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "003536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andres Adonis Estevez, OTR/L
• Noreen C Etienne
• Evergreen Adult Daycare Center, Inc.
• Eye Specialists of New York, PC
• Eyecare Advantage, Inc.
• Danielle Faxon
• Maria E Fee, CCC-SLP
• Shara J Feldman, PH.D.
• Karen Feng
• Wen Feng

• Home Health Agency in Corona, NY
• Providers in Corona, NY by specialty
• Home Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.