Individual
TONY CHUKWUEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
15 WEST 18TH STREET, LINDEN, NJ 07036
(845) 564-9853
(845) 564-6974
Mailing address
15 WEST 18TH STREET, LINDEN, NJ 07036
(845) 564-9853
(845) 564-6974
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
005317-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005317-1
PTA LICENSE
NY
Enumeration date
05/01/2007
Last updated
07/08/2007
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