Healthcare Provider Details

I. General information

NPI: 1285514265
Provider Name (Legal Business Name): OLUROTOLA OGUNYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 STERNADORI RD
SOMERVILLE NJ
08876-3297
US

IV. Provider business mailing address

58 STERNADORI RD
SOMERVILLE NJ
08876-3297
US

V. Phone/Fax

Practice location:
  • Phone: 732-242-2980
  • Fax:
Mailing address:
  • Phone: 732-242-2980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: