Healthcare Provider Details

I. General information

NPI: 1164956231
Provider Name (Legal Business Name): BMB CONSULTANTS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 TILTON RD
EGG HARBOR TOWNSHIP NJ
08234-1829
US

IV. Provider business mailing address

2626 TILTON RD
EGG HARBOR TOWNSHIP NJ
08234-1829
US

V. Phone/Fax

Practice location:
  • Phone: 866-277-5223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. EWAEN OSAMUYI OKAO
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 609-798-0551