Provider Demographics
NPI:1841361268
Name:ORAEDU, NNEKA CHIKODILI (MD)
Entity type:Individual
Prefix:DR
First Name:NNEKA
Middle Name:CHIKODILI
Last Name:ORAEDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 IRVINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2208
Mailing Address - Country:US
Mailing Address - Phone:973-761-1067
Mailing Address - Fax:973-761-1069
Practice Address - Street 1:211 IRVINGTON AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2208
Practice Address - Country:US
Practice Address - Phone:973-761-1067
Practice Address - Fax:973-761-1069
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08164500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0136671Medicaid