Provider Demographics
NPI:1396185567
Name:EMELUMBA, JUDE CHINETO (APN, PMHNP)
Entity Type:Individual
Prefix:MR
First Name:JUDE
Middle Name:CHINETO
Last Name:EMELUMBA
Suffix:
Gender:M
Credentials:APN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 FORREST ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2239
Mailing Address - Country:US
Mailing Address - Phone:551-247-8105
Mailing Address - Fax:
Practice Address - Street 1:314 E STATE ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08608
Practice Address - Country:US
Practice Address - Phone:609-396-5944
Practice Address - Fax:609-394-0405
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00443500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0382914Medicaid