Healthcare Provider Details

I. General information

NPI: 1689537631
Provider Name (Legal Business Name): JOE A OLOBOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PATERSON PLANK RD # 8000
UNION CITY NJ
07087-3416
US

IV. Provider business mailing address

500 PATERSON PLANK RD # 8000
UNION CITY NJ
07087-3416
US

V. Phone/Fax

Practice location:
  • Phone: 646-286-1284
  • Fax:
Mailing address:
  • Phone: 646-286-1284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: