Individual
INIOBONG UKONNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 BAY AVE, MONTCLAIR, NJ 07042-4837
(973) 330-1269
Mailing address
799 BLOOMFIELD AVE STE 201, VERONA, NJ 07044-1374
(973) 746-7050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA10901400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2018
Last updated
10/09/2020
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