Provider Demographics
NPI:1801163480
Name:CHIMEZIE, IJEOMA (PHARMD)
Entity type:Individual
Prefix:
First Name:IJEOMA
Middle Name:
Last Name:CHIMEZIE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 ROSELYN PL
Mailing Address - Street 2:
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-1216
Mailing Address - Country:US
Mailing Address - Phone:908-721-7225
Mailing Address - Fax:
Practice Address - Street 1:31 ROSELYN PL
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1216
Practice Address - Country:US
Practice Address - Phone:908-721-7225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-25
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03461800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist