Provider Demographics
NPI:1891262663
Name:DURUEKE, FELIX OBINNA (BA)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:OBINNA
Last Name:DURUEKE
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 KERRIGAN BLVD FL 1
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-2915
Mailing Address - Country:US
Mailing Address - Phone:862-235-9710
Mailing Address - Fax:
Practice Address - Street 1:410 KERRIGAN BLVD FL 1
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-2915
Practice Address - Country:US
Practice Address - Phone:862-235-9710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0282800163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health