Provider Demographics
NPI:1235743618
Name:IGBINEWEKA, JUDE (MD)
Entity Type:Individual
Prefix:
First Name:JUDE
Middle Name:
Last Name:IGBINEWEKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 HUNT ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2707
Mailing Address - Country:US
Mailing Address - Phone:781-963-0701
Mailing Address - Fax:781-963-0701
Practice Address - Street 1:58 HUNT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2707
Practice Address - Country:US
Practice Address - Phone:781-963-0701
Practice Address - Fax:781-963-0701
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker