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General NPI Number Information
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NPI Number | 1942716444
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Entity Type | Individual
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Provider Name | WILLIAM FONCHAM NGWA FNP-PMHNP
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Gender | Male
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 1100 LIBERTY PL
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-5708
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Country | US
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Telephone | 856-981-2891
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 LIBERTY PL
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-5708
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Country | US
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Telephone | 856-981-2891
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LG-0001203
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ00769100
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License Number State | NJ
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