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NPI Code Detail

MEDICARE: MS. GBEMISOLA J ALLI APN

MEDICARE: MS. GBEMISOLA J ALLI APN
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
1363LP2300XPrimary Care Nurse Practitioner26NJ00743800NJ

General Provider Information

NPI Number : 1336667237
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GBEMISOLA J ALLI APN
Provider Business Mailing Address
First Line : 21 EDGEWOOD ROAD
Second Line :
City : SUMMIT
State : NJ
Zip : 07901
Country : US
Telephone Number : 973-395-1550
Fax Number : 973-395-1556
Provider Business Practice Location Address
First Line : 85 WOODLAND RD
Second Line :
City : SHORT HILLS
State : NJ
Zip : 07078-2449
Country : US
Telephone Number : 973-379-4496
Fax Number : 973-376-0357
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2017
Last Update Date : 08/26/2021

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