Healthcare Provider Details

I. General information

NPI: 1891604104
Provider Name (Legal Business Name): EVA OBUOBI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 POCONO RD
DENVILLE NJ
07834-2954
US

IV. Provider business mailing address

25 POCONO RD
DENVILLE NJ
07834-2954
US

V. Phone/Fax

Practice location:
  • Phone: 862-235-8920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15631300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: