Individual
DR. NOEL ILOGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33 CLYDE RD, STE 105, SOMERSET, NJ 08873-5032
(732) 247-9001
(732) 463-2945
Mailing address
33 CLYDE RD, SUITE 105, SOMERSET, NJ 08873-5032
(732) 247-9001
(732) 247-9002
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA06645800
NJ
207RA0401X
Addiction Medicine (Internal Medicine) Physician
25MA06645800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223638353
TAX ID
NJ
01
—
462180488
TAX ID
NJ
05
—
7993501
—
NJ
Enumeration date
09/16/2006
Last updated
06/12/2024
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