Provider Demographics
NPI:1508557729
Name:AZUBUIKE, CHIDIEBERE EPHRAIM
Entity Type:Individual
Prefix:
First Name:CHIDIEBERE
Middle Name:EPHRAIM
Last Name:AZUBUIKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 HOUSELL CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-2615
Mailing Address - Country:US
Mailing Address - Phone:732-343-5374
Mailing Address - Fax:
Practice Address - Street 1:900 EASTON AVENUE
Practice Address - Street 2:STE 26
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-343-5374
Practice Address - Fax:732-960-1956
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator