Individual
MR. BENNETH IFEYANYI MEKOBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1203 W ST GEORGE AVE, LINDEN, NJ 07036
(908) 583-5151
Mailing address
586 WOODSIDE AVE, ROSELLE, NJ 07203
(973) 495-7914
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ14895300
NJ
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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