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General NPI Number Information
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NPI Number | 1376261594
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Entity Type | Organization
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Legal Business Name | RESTORED MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 261 CARNEGIE PL
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City | VAUXHALL
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State | NJ
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Zip | 07088-1334
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Country | US
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Telephone | 973-289-5189
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Fax |
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Provider Business Mailing Address
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Address Line | 803 KENILWORTH BLVD STE 220
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City | KENILWORTH
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State | NJ
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Zip | 07033-1719
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DR. JOSHUA ODERANTI
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Credential | DNP APRN, FNP/PMHNP
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Telephone | 973-520-7322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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