Provider Demographics
NPI:1447852900
Name:IGBOKWE, JADE HEATHER (AUD)
Entity type:Individual
Prefix:DR
First Name:JADE
Middle Name:HEATHER
Last Name:IGBOKWE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:JADE
Other - Middle Name:HEATHER
Other - Last Name:FAULKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:33 COLE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1117
Mailing Address - Country:US
Mailing Address - Phone:631-835-7848
Mailing Address - Fax:
Practice Address - Street 1:340 E NORTHFIELD RD STE 2B
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4892
Practice Address - Country:US
Practice Address - Phone:973-577-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00109800231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist