Healthcare Provider Details

I. General information

NPI: 1487228524
Provider Name (Legal Business Name): NKOLIKA JEAN ODENIGBO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. NKOLIKA JEAN NDINECHI

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 REHILL AVE
SOMERVILLE NJ
08876-2519
US

IV. Provider business mailing address

48 GRANT AVE
EAST HANOVER NJ
07936-2952
US

V. Phone/Fax

Practice location:
  • Phone: 908-685-2200
  • Fax:
Mailing address:
  • Phone: 862-888-4137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number331272
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA13152600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: