Healthcare Provider Details
I. General information
NPI: 1083104566
Provider Name (Legal Business Name): JOSHUA ONONUJU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/10/2018
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
160 W 26TH ST
NEW YORK NY
10001-6975
US
IV. Provider business mailing address
160 W 26TH ST
NEW YORK NY
10001-6975
US
V. Phone/Fax
- Phone: 212-924-2510
- Fax: 212-812-3800
- Phone: 212-924-2510
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD474793 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 319368 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 25MA12311700 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: