NPIMap

Organization Active NPI

Nwankwo G Medical Services, LLC

  • Health Maintenance Organization
  • Irvington, NJ
National Provider Identifier
1316207541
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
25MB07208100 Issued in NJ
Legal business name
NWANKWO G MEDICAL SERVICES, LLC
Doing business as
Nwankwo G Medical Services, LLC
Practice address
22 Union Ave
Irvington, NJ 07111-5574
Phone
(973) 416-4111
Fax
(973) 416-4133
NPI assigned
May 22, 2012
Last updated
Nov 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Authorized official

Name
Dr. Gloria O NwankwoNPI 1134113939
Title
Owner/Physician
Phone
(973) 416-4111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 25MB07208100 NJ Primary

Addresses

Primary practice location

22 Union Ave
Irvington, NJ 07111-5574

Mailing address

22 Union Ave
Irvington, NJ 07111-5574
Phone (973) 416-4111

Other names 1

  • NWANKWO G MEDICAL SERVICES, LLC Doing business as

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": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1316207541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 UNION AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071115574",
            "telephone_number": "973-416-4111",
            "fax_number": "973-416-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 UNION AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071115574",
            "telephone_number": "973-416-4111",
            "fax_number": "973-416-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NWANKWO G MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "NWANKWO",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "973-416-4111",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NJ",
            "license": "25MB07208100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NWANKWO G MEDICAL SERVICES, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NWANKWO G MEDICAL SERVICES, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.