Provider Demographics
NPI:1770907784
Name:UBAH, CHINYERE EVANGELINE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:CHINYERE
Middle Name:EVANGELINE
Last Name:UBAH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MS
Other - First Name:CHINYERE
Other - Middle Name:EVANGELINE
Other - Last Name:OHAEGBULEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 TOWNSEND AVE
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-9011
Mailing Address - Country:US
Mailing Address - Phone:609-248-0155
Mailing Address - Fax:
Practice Address - Street 1:100 TOWNSEND AVE
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-9011
Practice Address - Country:US
Practice Address - Phone:609-534-9196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00489500363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily