Healthcare Provider Details

I. General information

NPI: 1790559169
Provider Name (Legal Business Name): JANE CHIOMA ANNORZIE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 PARK AVE
PLAINFIELD NJ
07060-3200
US

IV. Provider business mailing address

1204 PARK AVE
PLAINFIELD NJ
07060-3200
US

V. Phone/Fax

Practice location:
  • Phone: 908-546-5041
  • Fax:
Mailing address:
  • Phone: 908-546-5041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04338400
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: