MEDICARE: UGOCHI JENNIFER AGWUNOBI

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	26NJ15583200	NJ

General Provider Information

NPI Number	:	1427981737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UGOCHI JENNIFER AGWUNOBI

Provider Business Mailing Address
First Line	:	806 MCCANDLESS ST
Second Line	:
City	:	LINDEN
State	:	NJ
Zip	:	07036-2345
Country	:	US
Telephone Number	:	862-600-7410
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 UNION AVE
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3277
Country	:	US
Telephone Number	:	973-993-7288
Fax Number	:

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

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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