Active NPI
Tony Chukwueke, PTA
- Child Intellectual and/or Developmental Disabilities Respite Care
- Linden, NJ
National Provider Identifier
1023239605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Intellectual and/or Developmental Disabilities Respite Care
- License
- 005317-1
- Practice address
- 15 West 18TH Street
Linden, NJ 07036 - Phone
- (845) 564-9853
- Fax
- (845) 564-6974
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | 005317-1 | NY | Primary |
Addresses
Primary practice location
15 West 18TH Street
Linden, NJ 07036
Mailing address
15 West 18TH Street
Linden, NJ 07036
Phone (845) 564-9853
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005317-1 | Other | NY | PTA LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005317-1 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023239605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 WEST 18TH STREET",
"city": "LINDEN",
"state": "NJ",
"postal_code": "07036",
"telephone_number": "845-564-9853",
"fax_number": "845-564-6974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 WEST 18TH STREET",
"city": "LINDEN",
"state": "NJ",
"postal_code": "07036",
"telephone_number": "845-564-9853",
"fax_number": "845-564-6974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUKWUEKE",
"first_name": "TONY",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": "NY",
"license": "005317-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTA LICENSE",
"identifier": "005317-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Linden, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.