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General NPI Number Information
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NPI Number | 1649072398
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Entity Type | Organization
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Legal Business Name | EVERPATH WELLNESS LLC
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 2 UNIVERSITY PLZ
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City | HACKENSACK
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State | NJ
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Zip | 07601-6202
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Country | US
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Telephone | 347-778-0507
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Fax |
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Provider Business Mailing Address
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Address Line | 252A CAMDEN ST
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City | NEWARK
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State | NJ
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Zip | 07103-2449
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Country | US
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Telephone | 347-778-0507
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Fax |
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Authorized Official
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Title or Position | APN
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Name | ABIMBOLA OTUFALE
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Credential |
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Telephone | 347-778-0507
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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 |
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License Number State |
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