Provider Demographics
NPI:1134440647
Name:NYAKU, AMESIKA N (MD, MS)
Entity type:Individual
Prefix:
First Name:AMESIKA
Middle Name:N
Last Name:NYAKU
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BERGEN ST
Mailing Address - Street 2:D LEVEL
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2496
Mailing Address - Country:US
Mailing Address - Phone:973-972-5111
Mailing Address - Fax:973-972-3102
Practice Address - Street 1:150 BERGEN ST
Practice Address - Street 2:D LEVEL
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2496
Practice Address - Country:US
Practice Address - Phone:973-972-5111
Practice Address - Fax:973-972-3102
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09952700207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease