Healthcare Provider Details

I. General information

NPI: 1073718185
Provider Name (Legal Business Name): OLADOTUN A OKUNOLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 08/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 MADISON AVENUE SUITE A6
MORRISTOWN NJ
07960
US

IV. Provider business mailing address

PO BOX 416457
BOSTON MA
02241-6457
US

V. Phone/Fax

Practice location:
  • Phone: 973-285-1446
  • Fax: 973-605-8854
Mailing address:
  • Phone: 844-362-1735
  • Fax: 973-290-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA08244900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: