Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00849500 | NJ |
NPI | 1023599578 |
---|---|
Provider Name | Dr. Ebere Aniegbuna |
First Address | Perth Amboy, NJ 08861-2979 |
Second Address | Perth Amboy, NJ 08861-2979 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2018 |
Last Update Date | 23/08/2018 |