Healthcare Provider Details

I. General information

NPI: 1639097546
Provider Name (Legal Business Name): CHINYERE NWANKWO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 STELTON RD
PISCATAWAY NJ
08854-3251
US

IV. Provider business mailing address

155 STELTON RD
PISCATAWAY NJ
08854-3251
US

V. Phone/Fax

Practice location:
  • Phone: 973-407-0872
  • Fax: 732-752-3957
Mailing address:
  • Phone: 973-407-0872
  • Fax: 732-752-3957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15601800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: