Healthcare Provider Details

I. General information

NPI: 1285496919
Provider Name (Legal Business Name): ESTHER A LAWAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 01/29/2024
Certification Date: 01/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 FIELDSTONE DR
LIVINGSTON NJ
07039-3308
US

IV. Provider business mailing address

3 FIELDSTONE DR
LIVINGSTON NJ
07039-3308
US

V. Phone/Fax

Practice location:
  • Phone: 973-945-0009
  • Fax:
Mailing address:
  • Phone: 973-945-0009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number945536
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: