Healthcare Provider Details

I. General information

NPI: 1790495174
Provider Name (Legal Business Name): CHIOMA NJOKU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 11/28/2022
Certification Date: 11/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 NORMA DR
SOUTH EUCLID OH
44121-3516
US

IV. Provider business mailing address

4330 NORMA DR
SOUTH EUCLID OH
44121-3516
US

V. Phone/Fax

Practice location:
  • Phone: 770-310-2332
  • Fax:
Mailing address:
  • Phone: 770-310-2332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: