Healthcare Provider Details

I. General information

NPI: 1124474804
Provider Name (Legal Business Name): CATHERINE OBANDO CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BROADWAY STE B-1
PATERSON NJ
07514-1524
US

IV. Provider business mailing address

1971 LONG TER
UNION NJ
07083-5406
US

V. Phone/Fax

Practice location:
  • Phone: 732-718-3893
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP016044
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP016044
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number26NR14461000
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP016044
License Number StatePA
# 5
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00786400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: