Individual
DR. GLORIA O NWANKWO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
155 JEFFERSON STREET, NEWARK, NJ 07105-1706
(973) 589-1300
Mailing address
66 WEST GILBERT STREET, 2ND FLOOR, RED BANK, NJ 07701-4918
(732) 212-0051
(732) 212-0052
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB07208100
NJ
207R00000X
Internal Medicine Physician
25MB07208100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8638900
—
NJ
01
—
P00411620
RAILROAD MEDICARE
NJ
Enumeration date
09/07/2005
Last updated
11/30/2010
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