MEDICARE: MARGARET MOJISOLA OJELADE

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
1	363LA2200X	Adult Health Nurse Practitioner	26NJ00102300	NJ

General Provider Information

NPI Number	:	1558830216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET MOJISOLA OJELADE

Provider Business Mailing Address
First Line	:	67 BOBOLINK CT
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-8450
Country	:	US
Telephone Number	:	201-704-7697
Fax Number	:

Provider Business Practice Location Address
First Line	:	32 MILL ST
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07501-1825
Country	:	US
Telephone Number	:	973-705-7700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2018
Last Update Date	:	11/24/2018

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