Provider Demographics
NPI:1871612879
Name:NDUKA W. ONWUKA MD PC
Entity type:Organization
Organization Name:NDUKA W. ONWUKA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:NDUKA
Authorized Official - Last Name:ONWUKA
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:973-345-9745
Mailing Address - Street 1:PO BOX 8011
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07653-8011
Mailing Address - Country:US
Mailing Address - Phone:973-345-9745
Mailing Address - Fax:
Practice Address - Street 1:295 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-2000
Practice Address - Country:US
Practice Address - Phone:973-345-9745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA66319261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7445008Medicaid