Individual
AKUWA D GBOGBOTSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
741 BROADWAY, NEWARK, NJ 07104-4309
(973) 483-1300
Mailing address
741 BROADWAY, NEWARK, NJ 07104-4309
(973) 483-1300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR17883100
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NJ01049700
NJ
Other
Enumeration date
07/28/2020
Last updated
08/27/2020
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