Healthcare Provider Details

I. General information

NPI: 1336088905
Provider Name (Legal Business Name): MORENIKE OLATUBOSUN RPH, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 TEANECK RD
TEANECK NJ
07666-4245
US

IV. Provider business mailing address

718 TEANECK RD
TEANECK NJ
07666-4245
US

V. Phone/Fax

Practice location:
  • Phone: 201-912-2021
  • Fax: 201-227-6048
Mailing address:
  • Phone: 201-912-2021
  • Fax: 201-227-6048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02583200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: