Healthcare Provider Details

I. General information

NPI: 1740156405
Provider Name (Legal Business Name): HADASSAH IFESANYA DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 SPRINGFIELD AVE
MAPLEWOOD NJ
07040-3437
US

IV. Provider business mailing address

1917 CHURCHILL DR
UNION NJ
07083-6301
US

V. Phone/Fax

Practice location:
  • Phone: 862-241-4960
  • Fax:
Mailing address:
  • Phone: 862-241-4960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number26NJ15420900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: