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General NPI Number Information
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NPI Number | 1326381203
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Entity Type | Individual
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Provider Name | NWAYIEZE CHISARA NDUKWE M.D.,MPH
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Gender | Female
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 1924 ESSEX AVE
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City | LINDEN
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State | NJ
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Zip | 07036-1445
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Country | US
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Telephone | 908-494-0836
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Fax |
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Provider Business Mailing Address
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Address Line | 45 SOUTH AVE W
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City | CRANFORD
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State | NJ
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Zip | 07016-2686
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Country | US
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Telephone | 908-858-2522
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Fax | 908-653-1806
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA10465700
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License Number State | NJ
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