Healthcare Provider Details

I. General information

NPI: 1912731654
Provider Name (Legal Business Name): TEMPLE HEALTH MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2913 ESSEX RD
GWYNN OAK MD
21207-5556
US

IV. Provider business mailing address

2913 ESSEX RD
GWYNN OAK MD
21207-5556
US

V. Phone/Fax

Practice location:
  • Phone: 973-981-3000
  • Fax: 623-666-6534
Mailing address:
  • Phone: 973-981-3000
  • Fax: 623-666-6534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FEMI OMIDIRE
Title or Position: OWNER
Credential:
Phone: 973-393-2296