Provider Demographics
NPI:1780332478
Name:NDAH, CHIZOBA JOY (CNP)
Entity type:Individual
Prefix:
First Name:CHIZOBA
Middle Name:JOY
Last Name:NDAH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BUSINESS ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-2105
Mailing Address - Country:US
Mailing Address - Phone:857-413-1926
Mailing Address - Fax:
Practice Address - Street 1:353 W CENTER ST
Practice Address - Street 2:
Practice Address - City:WEST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379-1625
Practice Address - Country:US
Practice Address - Phone:508-857-0765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-12
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2261677163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent