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General NPI Number Information
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NPI Number | 1134634462
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Entity Type | Organization
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Legal Business Name | L&A ABSOLUTE CARE LLC
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 50 UNION AVE STE 701
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City | IRVINGTON
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State | NJ
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Zip | 07111-3292
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Country | US
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Telephone | 973-849-6030
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Fax |
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Provider Business Mailing Address
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Address Line | 1577 RIDGEWAY ST
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City | UNION
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State | NJ
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Zip | 07083-5129
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Country | US
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Telephone | 973-342-5457
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Fax |
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Authorized Official
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Title or Position | APN
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Name | MRS. ADEBOLA S AJANAKU
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Credential |
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Telephone | 973-342-5457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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