Provider Demographics
NPI:1093113334
Name:UDECHUKWU, ESTHER O (RDN)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:O
Last Name:UDECHUKWU
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 WOODSIDE RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1951
Mailing Address - Country:US
Mailing Address - Phone:862-766-0829
Mailing Address - Fax:862-766-0829
Practice Address - Street 1:94 WOODSIDE RD
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-1951
Practice Address - Country:US
Practice Address - Phone:862-766-0829
Practice Address - Fax:862-766-0829
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-19
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ133V00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered