Provider Demographics
NPI:1255828091
Name:NJEZE, CHIBUZO (RPH)
Entity Type:Individual
Prefix:
First Name:CHIBUZO
Middle Name:
Last Name:NJEZE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 560
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-0560
Mailing Address - Country:US
Mailing Address - Phone:973-372-1300
Mailing Address - Fax:973-372-0303
Practice Address - Street 1:4 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1920
Practice Address - Country:US
Practice Address - Phone:973-372-1300
Practice Address - Fax:973-372-0303
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02123200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist