Healthcare Provider Details

I. General information

NPI: 1982989588
Provider Name (Legal Business Name): HILDA UGHIE ALUKO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2011
Last Update Date: 07/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 BERGEN ST GA 227
NEWARK NJ
07107-3001
US

IV. Provider business mailing address

65 BERGEN ST # 845
NEWARK NJ
07107-3001
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-8946
  • Fax:
Mailing address:
  • Phone: 973-972-8946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00348600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: