Provider Demographics
NPI:1780043224
Name:EGWU, JOY (NP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:EGWU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 W 227TH ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501
Mailing Address - Country:US
Mailing Address - Phone:646-244-4368
Mailing Address - Fax:
Practice Address - Street 1:1640 W 227TH ST
Practice Address - Street 2:APT. 1
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-6632
Practice Address - Country:US
Practice Address - Phone:646-244-4368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily