Provider Demographics
NPI:1710660832
Name:EWING MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:EWING MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APN
Authorized Official - Prefix:MS
Authorized Official - First Name:NGOZI
Authorized Official - Middle Name:
Authorized Official - Last Name:NKEMKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-558-6583
Mailing Address - Street 1:100 HORIZON CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-1910
Mailing Address - Country:US
Mailing Address - Phone:609-558-6583
Mailing Address - Fax:
Practice Address - Street 1:100 HORIZON CENTER BLVD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08691-1910
Practice Address - Country:US
Practice Address - Phone:609-558-6583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty