Provider Demographics
NPI:1609036599
Name:AMADI, NKECHINYERE (MD)
Entity Type:Individual
Prefix:
First Name:NKECHINYERE
Middle Name:
Last Name:AMADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4514
Mailing Address - Country:US
Mailing Address - Phone:609-394-4111
Mailing Address - Fax:609-394-7040
Practice Address - Street 1:433 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4514
Practice Address - Country:US
Practice Address - Phone:609-394-4111
Practice Address - Fax:609-394-7040
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA083564207V00000X
NJ25MA08356400207VB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VB0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObesity Medicine
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1879660/9634144OtherAETNA HMO/PPO
NJ7613454OtherCIGNA
NJ0167185Medicaid
NJ0167185Medicaid