Provider Demographics
NPI:1639607039
Name:UGBOAJA, MERCY AMUCHE (APN)
Entity Type:Individual
Prefix:MRS
First Name:MERCY
Middle Name:AMUCHE
Last Name:UGBOAJA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HORIZON CENTER BLVD
Mailing Address - Street 2:SUITE 117,
Mailing Address - City:HAMILTON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08691
Mailing Address - Country:US
Mailing Address - Phone:732-357-7188
Mailing Address - Fax:
Practice Address - Street 1:100 HORIZON CENTER BLVD
Practice Address - Street 2:SUITE 117
Practice Address - City:HAMILTON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08691
Practice Address - Country:US
Practice Address - Phone:732-357-7188
Practice Address - Fax:862-233-2133
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC005540363LP0808X
NJ26NJ00709400363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health