Provider Demographics
NPI:1114969870
Name:ONYEADOR, BEATRICE (MD)
Entity Type:Individual
Prefix:DR
First Name:BEATRICE
Middle Name:
Last Name:ONYEADOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-4069
Mailing Address - Country:US
Mailing Address - Phone:973-340-1222
Mailing Address - Fax:
Practice Address - Street 1:304 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-4069
Practice Address - Country:US
Practice Address - Phone:973-478-8600
Practice Address - Fax:973-478-8601
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA073452207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8897808Medicaid
NJH69481Medicare UPIN
NJ062700Medicare ID - Type Unspecified