Provider Demographics
NPI:1568428449
Name:NJOKU, EDWIN AMOBI (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:AMOBI
Last Name:NJOKU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:589 BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-3537
Mailing Address - Country:US
Mailing Address - Phone:860-528-8200
Mailing Address - Fax:860-622-0869
Practice Address - Street 1:587 BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-3537
Practice Address - Country:US
Practice Address - Phone:860-528-8200
Practice Address - Fax:860-622-0872
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039145207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010039145CT02OtherBLUE CROSS/BLUE SHIELD
CT751666OtherCONNECTICARE
CT8210624/002OtherCIGNA
CT00139145801OtherBLUE CARE FAMILY
CT2122846OtherUNITED HEALTHCARE
CT2807130OtherAETNA (HMO)
CT2V1910OtherHEALTHNET/HUSKY
CTP2530127OtherOXFORD
CO198626OtherPREFERRED ONE
CO198626OtherPREFERRED ONE