Healthcare Provider Details

I. General information

NPI: 1457159196
Provider Name (Legal Business Name): CHARITY OSOBI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 BURNETT AVE
MAPLEWOOD NJ
07040-2916
US

IV. Provider business mailing address

37 BURNETT AVE
MAPLEWOOD NJ
07040-2916
US

V. Phone/Fax

Practice location:
  • Phone: 862-368-2160
  • Fax:
Mailing address:
  • Phone: 862-368-2160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15297100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: