Healthcare Provider Details

I. General information

NPI: 1215828694
Provider Name (Legal Business Name): JOSIAH OKOROM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 ROBERT PL
SOUTH PLAINFIELD NJ
07080-2949
US

IV. Provider business mailing address

142 ROBERT PL
SOUTH PLAINFIELD NJ
07080-2949
US

V. Phone/Fax

Practice location:
  • Phone: 908-941-6092
  • Fax:
Mailing address:
  • Phone: 908-941-6092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: