Provider Demographics
NPI:1235539420
Name:EKEMEZIE, UGOCHI CHIAZOM (APN)
Entity Type:Individual
Prefix:MRS
First Name:UGOCHI
Middle Name:CHIAZOM
Last Name:EKEMEZIE
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 1:113 S JOHNSTON AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08609-1821
Mailing Address - Country:US
Mailing Address - Phone:609-510-2334
Mailing Address - Fax:
Practice Address - Street 1:2550 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08609-1821
Practice Address - Country:US
Practice Address - Phone:609-396-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00477900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health