Healthcare Provider Details

I. General information

NPI: 1356151732
Provider Name (Legal Business Name): TOYIN NDIFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 S 12TH ST
NEWARK NJ
07103-4344
US

IV. Provider business mailing address

713 S 12TH ST
NEWARK NJ
07103-4344
US

V. Phone/Fax

Practice location:
  • Phone: 862-320-4381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NR24982200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: