Healthcare Provider Details

I. General information

NPI: 1033048665
Provider Name (Legal Business Name): IFEOMA NWAFOR APN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 JFK PKWY FL 1
SHORT HILLS NJ
07078-2713
US

IV. Provider business mailing address

51 JFK PKWY FL 1
SHORT HILLS NJ
07078-2713
US

V. Phone/Fax

Practice location:
  • Phone: 908-447-4996
  • Fax: 908-382-2551
Mailing address:
  • Phone: 908-447-4996
  • Fax: 908-382-2551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15576000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: