Individual
DR. KWAMI DELALI AGBODZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 WESTLAKE CT, JACKSON, NJ 08527-5160
(732) 961-6453
(732) 961-6453
Mailing address
15 WESTLAKE CT, JACKSON, NJ 08527-5160
(732) 961-6453
(732) 961-6453
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
9500799
NC
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
20436001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6420109
—
NJ
Enumeration date
08/09/2005
Last updated
07/08/2025
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