Healthcare Provider Details

I. General information

NPI: 1316616915
Provider Name (Legal Business Name): ABEMWENSE OMEDE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 WALTER E FORAN BLVD STE 302
FLEMINGTON NJ
08822-4668
US

IV. Provider business mailing address

PO BOX 22581
NEW YORK NY
10087-2581
US

V. Phone/Fax

Practice location:
  • Phone: 908-284-5288
  • Fax:
Mailing address:
  • Phone: 856-669-6050
  • Fax: 856-528-3117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number348278
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01219400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: