Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 26NJ00988200 | NJ |
N | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00988200 | NJ |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NJ00988200 | NJ |
NPI | 1639706286 |
---|---|
Provider Name | Dr. Ijechi Ndidi Ngumah |
First Address | Fanwood, NJ 07023-1657 |
Second Address | Jersey City, NJ 07302-4321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2020 |
Last Update Date | 05/11/2020 |