Healthcare Provider Details

I. General information

NPI: 1548648504
Provider Name (Legal Business Name): ESTHER OGUNYEMI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 SHREWSBURY AVE STE 4
SHREWSBURY NJ
07702-4179
US

IV. Provider business mailing address

PO BOX 188
LITTLE SILVER NJ
07739-0188
US

V. Phone/Fax

Practice location:
  • Phone: 732-264-1127
  • Fax: 732-264-0670
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number306882
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25MA10629000
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA10629000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: