Healthcare Provider Details

I. General information

NPI: 1013565886
Provider Name (Legal Business Name): OLUWASEUN TITILOPE ADEOTI N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS OLUWASEUN TITILOPE OMODARA

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MAY TER
VAUXHALL NJ
07088-1212
US

IV. Provider business mailing address

20 MAY TER
VAUXHALL NJ
07088-1212
US

V. Phone/Fax

Practice location:
  • Phone: 908-296-7963
  • Fax: 973-351-1288
Mailing address:
  • Phone: 908-296-7963
  • Fax: 973-351-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00948800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF344464-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00948800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: