Provider Demographics
NPI:1487043089
Name:NJOKU, ANTHONY OGBONNAYA (MED, M SC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:OGBONNAYA
Last Name:NJOKU
Suffix:
Gender:M
Credentials:MED, M SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LAMP POST LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1208
Mailing Address - Country:US
Mailing Address - Phone:215-219-5172
Mailing Address - Fax:
Practice Address - Street 1:19 LAMP POST LN
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1208
Practice Address - Country:US
Practice Address - Phone:215-219-5172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001303101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health