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NPI Code Detail

MEDICARE: ABEMWENSE OMEDE NP-C

MEDICARE: ABEMWENSE OMEDE NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner348278NY
2363LF0000XFamily Nurse Practitioner26NJ01219400NJ

General Provider Information

NPI Number : 1316616915
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABEMWENSE OMEDE NP-C
Provider Business Mailing Address
First Line : PO BOX 22581
Second Line :
City : NEW YORK
State : NY
Zip : 10087-2581
Country : US
Telephone Number : 856-669-6050
Fax Number : 856-528-3117
Provider Business Practice Location Address
First Line : 4 WALTER E FORAN BLVD STE 302
Second Line :
City : FLEMINGTON
State : NJ
Zip : 08822-4668
Country : US
Telephone Number : 908-284-5288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2021
Last Update Date : 06/11/2026

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