Provider Demographics
NPI:1033323845
Name:ANOSIKE, OLUCHI U (APN)
Entity Type:Individual
Prefix:
First Name:OLUCHI
Middle Name:U
Last Name:ANOSIKE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-2723
Mailing Address - Country:US
Mailing Address - Phone:732-541-6073
Mailing Address - Fax:732-235-4321
Practice Address - Street 1:80 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-2723
Practice Address - Country:US
Practice Address - Phone:732-541-6073
Practice Address - Fax:732-235-4321
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00106500363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ131719AHEMedicare PIN