Individual
MR. JOHN D CHUKWUDIFU JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
550 N 12TH ST, LEMOYNE, PA 17043-1242
(732) 586-4101
Mailing address
227 KRISTY LN, HARRISBURG, PA 17111-5041
(732) 586-4101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA062595
PA
363AM0700X
Medical Physician Assistant
C5-0001183
DE
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
09/20/2017
Last updated
09/09/2021
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