Provider Demographics
NPI:1972964344
Name:AJUBA-IWUJI, NNEKA (PHARMD)
Entity Type:Individual
Prefix:
First Name:NNEKA
Middle Name:
Last Name:AJUBA-IWUJI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:NNEKA
Other - Middle Name:
Other - Last Name:WOOTEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:130 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:PENNS GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08069
Mailing Address - Country:US
Mailing Address - Phone:856-299-9462
Mailing Address - Fax:856-299-7561
Practice Address - Street 1:130 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:PENNS GROVE
Practice Address - State:NJ
Practice Address - Zip Code:08069
Practice Address - Country:US
Practice Address - Phone:856-299-9462
Practice Address - Fax:856-299-7561
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03021700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist