Healthcare Provider Details

I. General information

NPI: 1922632520
Provider Name (Legal Business Name): FOLAWEWO ABIODUN AJAYI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2020
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 KLEMM AVE
GLOUCESTER CITY NJ
08030-1627
US

IV. Provider business mailing address

534 MAIDSTONE DR
WILLIAMSTOWN NJ
08094-1676
US

V. Phone/Fax

Practice location:
  • Phone: 856-282-5566
  • Fax: 856-396-9917
Mailing address:
  • Phone: 856-341-6408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ01012000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: