Doctor Name: | SYLVESTER O NWOSU |
NPI Number: | 1073856944 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 26NJ00421500 |
Business Practice Address: | 830 Bear Tavern Rd Ewing, NJ - 086281020 |
Business Phone Number: | 8003703651 |
Business Fax Number: | |
Mailing Address: | 20 Research Pkwy, OLD SAYBROOK |
State: | CT |
Postal Code: | 064754214 |
Phone Number: | 8003703651 |
Fax Number: | 8605100020 |
NPI Enumeration Date: | 03/29/2013 |
NPI Last Update Date: | 06/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 26NJ00421500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |