Healthcare Provider Details

I. General information

NPI: 1699349399
Provider Name (Legal Business Name): NGOZI ATTRACTA OCHIORA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 05/17/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 RANDOLPH DR
MOUNT HOLLY NJ
08060-1105
US

IV. Provider business mailing address

14 RANDOLPH DR
MOUNT HOLLY NJ
08060-1105
US

V. Phone/Fax

Practice location:
  • Phone: 609-267-1647
  • Fax:
Mailing address:
  • Phone: 609-267-1647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ01147800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: