Provider Demographics
NPI:1376974147
Name:ONYEMEKEIHIA, MARIE (BA,SPECEDUCTEACHER)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:
Last Name:ONYEMEKEIHIA
Suffix:
Gender:F
Credentials:BA,SPECEDUCTEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LISA CT FL 3
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-1181
Mailing Address - Country:US
Mailing Address - Phone:973-351-6689
Mailing Address - Fax:
Practice Address - Street 1:7 LISA CT FL 3
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-1181
Practice Address - Country:US
Practice Address - Phone:973-351-6689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ864330222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist