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General NPI Number Information
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NPI Number | 1235760984
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Entity Type | Individual
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Provider Name | FEMI RAMAT OMIDIRE APN
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Gender | Male
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Dates
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Enumeration Date | 01/31/2020
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 40 UNION AVE STE 301
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City | IRVINGTON
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State | NJ
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Zip | 07111-3290
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Country | US
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Telephone | 973-393-2296
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Fax | 862-849-2319
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Provider Business Mailing Address
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Address Line | 837 INWOOD RD
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City | UNION
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State | NJ
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Zip | 07083-6558
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Country | US
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Telephone | 973-393-2296
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Fax | 862-849-2319
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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 | 26NJ01012700
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License Number State | NJ
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