Provider Demographics
NPI:1538548466
Name:EJIOFOR, CHINONYEREM IKENNA (DC)
Entity type:Individual
Prefix:DR
First Name:CHINONYEREM
Middle Name:IKENNA
Last Name:EJIOFOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 PATERSON PLANK RD
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-3247
Mailing Address - Country:US
Mailing Address - Phone:201-293-4697
Mailing Address - Fax:201-552-2245
Practice Address - Street 1:1255 PATERSON PLANK RD
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3247
Practice Address - Country:US
Practice Address - Phone:201-293-4697
Practice Address - Fax:201-552-2245
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00724700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor