Individual
OMOROVBIYE EWEKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1980 SPRINGFIELD AVE STE 9D, MAPLEWOOD, NJ 07040-3438
(973) 762-1800
(973) 762-1808
Mailing address
570 S 10TH ST # 3, NEWARK, NJ 07103-1827
(908) 422-3146
(973) 762-1808
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9084223146
—
NJ
05
—
9737621800
—
NJ
Enumeration date
03/25/2019
Last updated
03/25/2019
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