Healthcare Provider Details

I. General information

NPI: 1114140050
Provider Name (Legal Business Name): KUMAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 COIT ST
IRVINGTON NJ
07111-4013
US

IV. Provider business mailing address

277 COIT ST
IRVINGTON NJ
07111-4013
US

V. Phone/Fax

Practice location:
  • Phone: 973-373-5100
  • Fax: 973-373-0510
Mailing address:
  • Phone: 973-373-5100
  • Fax: 973-373-0510

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. ADEKUNLE GBADEGESIN ADEOTI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 973-373-5100