Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 25MB08977000 | NJ |
NPI | 1023267465 |
---|---|
Provider Name | Dr. Chioma A Ezeadichie |
First Address | Lancaster, PA 17604-7776 |
Second Address | Hammonton, NJ 08037-3347 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2008 |
Last Update Date | 07/11/2017 |