Healthcare Provider Details

I. General information

NPI: 1376464743
Provider Name (Legal Business Name): DONNIE OGBUDINKPA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 RIVER ST STE 9
HOBOKEN NJ
07030-5990
US

IV. Provider business mailing address

14 WYNDMERE RD
EVESHAM NJ
08053-1916
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax:
Mailing address:
  • Phone: 973-699-1805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15540500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: