Healthcare Provider Details

I. General information

NPI: 1134886773
Provider Name (Legal Business Name): NJI HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WOOD AVE S STE 600
ISELIN NJ
08830-2717
US

IV. Provider business mailing address

33 WOOD AVE S STE 600
ISELIN NJ
08830-2717
US

V. Phone/Fax

Practice location:
  • Phone: 732-986-4841
  • Fax: 973-200-8137
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NNEKA MAZAGWU
Title or Position: MANAGER
Credential:
Phone: 732-986-4841