Doctor Name: | TONY CHUKWUEKE |
NPI Number: | 1023239605 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PTA |
License Number: | 005317-1 |
Business Practice Address: | 15 West 18th Street Linden, NJ - 07036 |
Business Phone Number: | 8455649853 |
Business Fax Number: | 8455646974 |
Mailing Address: | 15 West 18th Street, LINDEN |
State: | NJ |
Postal Code: | 07036 |
Phone Number: | 8455649853 |
Fax Number: | 8455646974 |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385HR2060X |
License Number: | 005317-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Taxonomy Definition: | A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers. |