Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC00702600 | NJ |
N | 111NN0400X | Neurology | 38MC00702600 | NJ |
N | 111NN1001X | Nutrition | 38MC00702600 | NJ |
N | 111NP0017X | Pediatric Chiropractor | 38MC00702600 | NJ |
N | 111NR0200X | Radiology | 38MC00702600 | NJ |
N | 213ER0200X | Radiology | 38MC00702600 | NJ |
N | 111NR0400X | Rehabilitation Chiropractor | 38MC00702600 | NJ |
N | 111NS0005X | Chiropractic Sports Physician | 38MC00702600 | NJ |
N | 111NX0100X | Occupational Health | 38MC00702600 | NJ |
NPI | 1972858736 |
---|---|
Provider Name | Dr. Ebenezer O-A Bilewu |
First Address | Galloway, NJ 08205-9418 |
Second Address | Galloway, NJ 08205-9418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2012 |
Last Update Date | 05/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3893359000 | AMERIHEALTH NEW JERSEY (01) | NJ |
3893360000 | AMERIHEALTH NEW JERSEY (01) | NJ |
60114338 | HORIZON NJ HEALTH (01) | NJ |