Healthcare Provider Details

I. General information

NPI: 1306759683
Provider Name (Legal Business Name): OYINKAN CHRISTIE ODUMOSU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OYINKAN CHRISTIE OGUN

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CENTRAL AVE
NEWARK NJ
07102-1909
US

IV. Provider business mailing address

78 CAROLINE AVE
ELMONT NY
11003-5019
US

V. Phone/Fax

Practice location:
  • Phone: 973-877-5025
  • Fax:
Mailing address:
  • Phone: 347-416-1639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number061580
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: