Provider Demographics
NPI:1689132292
Name:UWAZURUONYE, JUDITH CHINONSO
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:CHINONSO
Last Name:UWAZURUONYE
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 1:14 RED GRAVEL CIR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-1672
Mailing Address - Country:US
Mailing Address - Phone:856-264-6915
Mailing Address - Fax:
Practice Address - Street 1:14 RED GRAVEL CIR
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-1672
Practice Address - Country:US
Practice Address - Phone:856-418-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01435700363LP0808X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450354007OtherHOME HEALTHCARE AGENCY