Provider Demographics
NPI:1306435284
Name:AKPUNONU, AMAKA
Entity type:Individual
Prefix:
First Name:AMAKA
Middle Name:
Last Name:AKPUNONU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ROUTE 130 S STE 520
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-2844
Mailing Address - Country:US
Mailing Address - Phone:215-868-4433
Mailing Address - Fax:
Practice Address - Street 1:101 ROUTE 130 S STE 520
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2844
Practice Address - Country:US
Practice Address - Phone:215-868-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13581100163W00000X
NJ26NJ01132900363LP0808X
PARN590523163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse