Provider Demographics
NPI:1821376682
Name:NWOSU, JENIFER CHIOMA (MD)
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:CHIOMA
Last Name:NWOSU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHIOMA
Other - Middle Name:JENIFER
Other - Last Name:NWOSU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:415 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-1804
Mailing Address - Country:US
Mailing Address - Phone:908-342-0405
Mailing Address - Fax:908-757-6422
Practice Address - Street 1:28 VALLEY RD # 148
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2709
Practice Address - Country:US
Practice Address - Phone:973-559-4600
Practice Address - Fax:855-998-4358
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09555700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine