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General NPI Number Information
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NPI Number | 1083250484
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Entity Type | Individual
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Provider Name | OLASUMBO OLADERU
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Gender | Male
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Dates
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Enumeration Date | 11/20/2019
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1901 N OLDEN AVENUE EXT STE 11A
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City | EWING
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State | NJ
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Zip | 08618-2100
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Country | US
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Telephone | 609-583-4969
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Fax | 609-323-7285
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Provider Business Mailing Address
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Address Line | 4 BOLEYN CT
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City | EWING
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State | NJ
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Zip | 08628-2231
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Country | US
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Telephone | 609-321-0233
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ00987800
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License Number State | NJ
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