Individual
CHIAZOKAM AGATHA EZEORAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
914-916 S 17TH ST APT 1, NEWARK, NJ 07108-1186
(347) 256-3065
Mailing address
914-916 S 17TH ST APT 1, NEWARK, NJ 07108-1186
(347) 256-3065
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ01401200
NJ
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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