# IMPACT MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336417476
- **Authorized official:** IHUOMA OTTIH NP (APN-C/ OWNER)
- **Authorized official phone:** (267) 474-1355

## Contact information

- **Practice address:** 244 AMAN AVE, CLEMENTON, NJ 08021-2502
- **Practice address phone:** (267) 474-1355
- **Mailing address:** 244 AMAN AVE, CLEMENTON, NJ 08021-2502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 26NJ00349900 | NJ | Yes |

## Other

- **Enumeration date:** 12/04/2011
- **Last updated:** 12/04/2011