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General NPI Number Information
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NPI Number | 1740549203
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Entity Type | Organization
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Legal Business Name | NWANKWO G MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 22 UNION AVE STE 105
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City | IRVINGTON
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State | NJ
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Zip | 07111-5574
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Country | US
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Telephone | 973-416-1111
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Fax | 973-416-4133
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Provider Business Mailing Address
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Address Line | 22 UNION AVE
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City | IRVINGTON
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State | NJ
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Zip | 07111-5574
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Country | US
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Telephone | 973-416-1111
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Fax | 973-416-4133
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. GLORIA O NWANKWO
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Credential | DO
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Telephone | 973-416-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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