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Individual

MR. NKEMDIRIM OTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2325 DELMAR AVE, VINELAND, NJ 08360-6819
(267) 237-6561
Mailing address
2325 DELMAR AVE, VINELAND, NJ 08360-6819
(267) 237-6561

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
26NR13397600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2156710323
NJ
Enumeration date
10/04/2019
Last updated
10/04/2019
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