MEDICARE: EDITH CHIZUBE ADIEZE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ14849200	NJ

General Provider Information

NPI Number	:	1104519578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDITH CHIZUBE ADIEZE

Provider Business Mailing Address
First Line	:	21 HEMINGWAY LN
Second Line	:
City	:	COLUMBUS
State	:	NJ
Zip	:	08022-2325
Country	:	US
Telephone Number	:	609-379-1351
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 HEMINGWAY LN
Second Line	:
City	:	COLUMBUS
State	:	NJ
Zip	:	08022-2325
Country	:	US
Telephone Number	:	609-379-1351
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2023
Last Update Date	:	01/15/2026

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Directions to “ EDITH CHIZUBE ADIEZE ” Practice Location

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