Healthcare Provider Details

I. General information

NPI: 1962777938
Provider Name (Legal Business Name): CHIZOBA ISIOMA OKWU DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2012
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 LAFAYETTE ST
NEWARK NJ
07105-1815
US

IV. Provider business mailing address

228 LAFAYETTE ST
NEWARK NJ
07105-1815
US

V. Phone/Fax

Practice location:
  • Phone: 973-789-8111
  • Fax: 973-789-8111
Mailing address:
  • Phone: 973-789-8111
  • Fax: 973-789-8407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00347000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: