Provider Demographics
NPI:1629451356
Name:NJIAJU, NGOZI UMUNNA
Entity Type:Individual
Prefix:
First Name:NGOZI
Middle Name:UMUNNA
Last Name:NJIAJU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23450 TAILOR SHOP PL
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4382
Mailing Address - Country:US
Mailing Address - Phone:240-888-1776
Mailing Address - Fax:240-597-5555
Practice Address - Street 1:13118 LAYHILL RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-3244
Practice Address - Country:US
Practice Address - Phone:240-888-1776
Practice Address - Fax:240-597-5555
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207502163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse