Healthcare Provider Details

I. General information

NPI: 1063255065
Provider Name (Legal Business Name): YAA SERWAAH OPARE- AFARI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 N BROAD ST FL 2
WOODBURY NJ
08096-4603
US

IV. Provider business mailing address

22 N BROAD ST FL 2
WOODBURY NJ
08096-4603
US

V. Phone/Fax

Practice location:
  • Phone: 856-436-0035
  • Fax: 833-740-4280
Mailing address:
  • Phone: 856-436-0035
  • Fax: 833-740-4280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15089600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: