Provider Demographics
NPI:1326807991
Name:ACHONYE, CHIOMA CHIATUOGU (APN)
Entity Type:Individual
Prefix:
First Name:CHIOMA
Middle Name:CHIATUOGU
Last Name:ACHONYE
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 1:2124 MELROSE PKWY
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-4382
Mailing Address - Country:US
Mailing Address - Phone:908-612-8372
Mailing Address - Fax:
Practice Address - Street 1:2124 MELROSE PKWY
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-4382
Practice Address - Country:US
Practice Address - Phone:908-612-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14930200363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology