Healthcare Provider Details

I. General information

NPI: 1962609909
Provider Name (Legal Business Name): DOROTHY OZURUMBA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 EASTON AVE STE 11-258
SOMERSET NJ
08873-1648
US

IV. Provider business mailing address

1075 EASTON AVE STE 11-630
SOMERSET NJ
08873-1648
US

V. Phone/Fax

Practice location:
  • Phone: 848-237-9715
  • Fax:
Mailing address:
  • Phone: 848-237-9715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00024900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: