Individual
DR. HENRY A ODUJEBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
495 N 13TH ST, NEWARK, NJ 07107-1317
(973) 268-1400
Mailing address
66 W GILBERT ST, TINTON FALLS, NJ 07701-4918
(732) 212-0060
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA05474800
NJ
208600000X
Surgery Physician
25MA05474800
NJ
208D00000X
General Practice Physician
25MA05474800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7025106
—
NJ
01
—
P00357155
RAILROAD MEDICARE
NJ
Enumeration date
09/07/2005
Last updated
11/09/2010
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