Healthcare Provider Details

I. General information

NPI: 1356801583
Provider Name (Legal Business Name): IFEYINWA NORBERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 BRUNSWICK AVE
TRENTON NJ
08638-4143
US

IV. Provider business mailing address

750 BRUNSWICK AVE
TRENTON NJ
08638-4143
US

V. Phone/Fax

Practice location:
  • Phone: 609-394-6031
  • Fax:
Mailing address:
  • Phone: 609-394-6031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberV5806
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: