Healthcare Provider Details

I. General information

NPI: 1831601939
Provider Name (Legal Business Name): OMOLOLA ARAGBADA APRN/PMNHP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 CHURCH ST FL 19
NEW HAVEN CT
06510-2100
US

IV. Provider business mailing address

157 CHURCH ST FL 19
NEW HAVEN CT
06510-2100
US

V. Phone/Fax

Practice location:
  • Phone: 860-792-5468
  • Fax:
Mailing address:
  • Phone: 860-792-5468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9825
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: