Organization Active NPI

Idama Healthcare

  • Health Service Clinic/Center
  • South Orange, NJ
National Provider Identifier
1093289852
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
IDAMA HEALTHCARE
Practice address
4 S Orange Ave Suite 253
South Orange, NJ 07079-1702
Phone
(862) 240-1615
Fax
(862) 367-8367
NPI assigned
Jan 15, 2019
Last updated
May 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amache Onyeani
Title
Manager
Phone
(908) 512-8724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

4 S Orange Ave Suite 253
South Orange, NJ 07079-1702

Mailing address

4 S Orange Ave # 253
South Orange, NJ 07079-1702
Phone (862) 240-1615

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1093289852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 S ORANGE AVE # 253",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791702",
            "telephone_number": "862-240-1615",
            "fax_number": "862-367-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 S ORANGE AVE SUITE 253",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791702",
            "telephone_number": "862-240-1615",
            "fax_number": "862-367-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAMA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-15",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "ONYEANI",
        "authorized_official_first_name": "AMACHE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "908-512-8724"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.