Provider Demographics
NPI:1851169536
Name:ESIELEM, MERIT UCHECHI
Entity Type:Individual
Prefix:
First Name:MERIT
Middle Name:UCHECHI
Last Name:ESIELEM
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 1:336 N 17TH ST
Mailing Address - Street 2:
Mailing Address - City:KENILWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07033-1075
Mailing Address - Country:US
Mailing Address - Phone:862-452-8234
Mailing Address - Fax:
Practice Address - Street 1:22 E SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-2936
Practice Address - Country:US
Practice Address - Phone:908-925-0704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP07085500164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse