Provider Demographics
NPI:1144950361
Name:NWOKORO, SABINA
Entity type:Individual
Prefix:
First Name:SABINA
Middle Name:
Last Name:NWOKORO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-1101
Mailing Address - Country:US
Mailing Address - Phone:908-251-3218
Mailing Address - Fax:
Practice Address - Street 1:339 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-1101
Practice Address - Country:US
Practice Address - Phone:908-251-3218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19947600163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJX3HZN41284260OtherBLUE CROSS BLUE SHIELD