Healthcare Provider Details

I. General information

NPI: 1609807379
Provider Name (Legal Business Name): PIUS CHIKEZIE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 01/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 LAHAWAY CREEK CT
MILLSTONE TOWNSHIP NJ
08510
US

IV. Provider business mailing address

PO BOX 356
PERRINEVILLE NJ
08535-0356
US

V. Phone/Fax

Practice location:
  • Phone: 908-770-8025
  • Fax: 732-321-1150
Mailing address:
  • Phone: 732-321-1100
  • Fax: 732-321-1150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA62398
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: