MEDICARE: NGOZICHUKWU OKWARA

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	26NJ15220800	NJ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP031096	PA

General Provider Information

NPI Number	:	1922820539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGOZICHUKWU OKWARA

Provider Business Mailing Address
First Line	:	2 CANARY RD
Second Line	:
City	:	LEVITTOWN
State	:	PA
Zip	:	19057-1602
Country	:	US
Telephone Number	:	215-910-1870
Fax Number	:

Provider Business Practice Location Address
First Line	:	822 KLEMM AVE
Second Line	:
City	:	GLOUCESTER CITY
State	:	NJ
Zip	:	08030-1627
Country	:	US
Telephone Number	:	856-237-3597
Fax Number	:

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

Provider Enumeration Date	:	10/26/2024
Last Update Date	:	05/30/2025

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Directions to “ NGOZICHUKWU OKWARA ” Practice Location

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